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The greatest postnatal killer of the nineteenth century was puerperal fever. A vicious and usually fatal form of septicaemia, puerperal or childbed fever was known to occur in maternity hospitals far more frequently than at home births, and to spread faster in crowded wards than in those with fewer patients. Its cause was unknown. In this precise statistical analysis of the facts, gathered from several sources across the major cities of Europe, Florence Nightingale (1820-1910) explores the mystery of puerperal fever and its possible causes. She stresses the necessity of good ventilation in hospitals, condemning those with overcrowded wards, and cites instances where the layout of wards has a noticeable correlation with the number of deaths. Published in 1871, just before Pasteur's work on germ theory proved that the problem could be all but eradicated if doctors washed their hands more rigorously, this work remains clear, scholarly and engaging.
Most people are familiar with the name of Florence Nightingale and the image of 'the lady with the lamp'. Initially celebrated for her efforts during the Crimean War, Nightingale is best known as a reformer of army medical services and of nursing more generally. She wrote Notes on Nursing - first published in 1859, but reprinted here in its revised and enlarged 1860 edition - in order to share her knowledge with women who were nursing their families at home. It was also required reading at the nursing school she opened at St Thomas' Hospital, the first of its kind, and at other such establishments. Still hailed today as important introductory reading for aspiring nurses, the text explains the centrality of ventilation, observation, hygiene, and diet during sickness, as well as care during convalescence. It also contains timeless instructions on how to nurture both the mind and body of the sick.
Returning from the Crimea, Florence Nightingale (1820-1910) used her experience of army medicine to ameliorate civilian nursing care. She was appalled by the conditions she found, affirming that the first requirement of a hospital was that 'it should do the sick no harm'. Problems such as overcrowding and damp, in addition to lack of ventilation and proper sanitation, contributed to high mortality rates. Nightingale's belief that such suffering was preventable was seen as revolutionary. In 1859 she published her two most influential works, Notes on Nursing (also reissued in this series) and Notes on Hospitals. This collection contains the two papers she presented to the National Association for the Promotion of Social Science in 1858. Also included, from 1857, is her evidence to the royal commission on the British army's sanitary conditions. Three illustrated articles on hospital design, published in The Builder in 1858, form an appendix to the work.
Calabria and Macrae provide the essence of Nightingale's spiritual philosophy by selecting and reorganizing her best-written treatments.
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