Bad State of Affairs at City Hospital in 1892

Kicked to the Board.  Bad State of Affairs at the City Hospital.  The Big Three at once Investigate the Charges and Decide a Change Is Badly Needed Mr. George Kitchen yesterday morning made complaint to the board of public works regarding existing affairs at the city hospital.  Mr. Kitchen is attending to the wants of Mr. Fayette Gentry, the wounded Coal Creek volunteer, who is confined there. Confined in the hospital are two negroes, patients of a physician of the E. T. V. & G. railroad company, Dr. Thomas.  These men were injured on the road, and the limb of one had to be amputated. Mr. Kitchen reported to the board that the wound of the negro whose leg was amputated was in a deplorable condition, and that the stench which came from the room in which the negroes were confined is almost unendurable.  He also charged the night negro nurse with sleeping while on duty, much to the suffering of the patients. The gentleman made no complaints against the management of the hospital, Miss Mosely, the matron, being particularly anxious to do anything and everything she could. Dr. Overton, the city physician also stated to the board the conditions of the patients, and considered it wise that a change of some sort be made. The board of public works at once visited the institution.  They found everything neat and clean as could be, but the condition of the negroes was such that the chairman of the board officially notified Major Huger, of the E. T. V. & G., of the existing circumstances and recommended that action be taken. Source:  Knoxville Daily Journal and Tribune, August 25, 1892, page 5   Dr. Thomas' Side.  What He Has To Say Regarding the Hospital Affair Knoxville, August 24, 1892. -- In justice to myself and the company which I represent, I deem it proper to publish the following statement: It is the habit of the railroad company to send such patients as are unprovided with homes to the Knoxville city hospital, paying said institution a specified sum per week for accommodations of each patient, and instructing the railroad surgeon to give them the necessary attention. On the 22d of July, 1892, I took one Henry Hern [sic], a negro, to the hospital, where a bed was given him in the negro ward, and I dressed his wounds.  I have continued to dress his wounds once, and often twice a day ever since. On the 13th of August I took one Geo. Smith to the city hospital, where an amputation of the left leg was done by our consulting surgeon, Dr. J. C. Cawood, assisted by Dr. Russell, of Athens, Dr. J. Overton, of this city, and myself.  Under the directions of the consulting surgeon, I removed the primary dressing on the third day thereafter, and have dressed the wound every day since.  From the very first I was compelled to complain of the inattention and neglect of the nurse and the failure of the people in charge of the hospital to keep the ward and bed clean. One day last week I made an urgent appeal to the matron of the hospital for clean sheets and bedding and a more careful attention to the general hygiene of the premises.  This appeal was overheard by the chairman of board [sic] of public works and one alderman and must have been viewed in the light of an offense, for I can think of no other ground upon which to base their action.  The amputation was successful and the result fairly good in spite of the unsanitary state of his surroundings thanks to my extreme precautions in the use of the very antiseptics which they assert I did not use.  There has never been any offensive discharge from this wound and the patient is doing as well as possible.  The limb is so far from being rotten that I hope to discharge the patient in a short time. It was the other patient that gave rise to the horrible odor which arose form his bed.  His was a fracture of one of the large bones of the pelvis, together with a laceration of the soft structures near it -- with necrosis of the bone.  The treatment was palliative and constructive until such a time as the patient could be toned up for an operation involving the removal of the dead bone together with careful cleansing of the wound. My patient himself gave me much trouble in disobeying my orders.  In the face of my directions to the nurse, this man was permitted to lie in the bed for a day or two at a time without any change of sheets, often without any sheet at all, and the mattress became charged with effete matters.  The discharge from the wound was offensive.  Pus from necrosed bone is always offensive -- especially so in the case of a negro.  Any surgeon will vouch for this.  I am prepared to make an affidavit to the fact that I used the most powerful antiseptics known to science and I used them freely every day, washing out the wound with solutions of bichloride of mercury, carbolic acid and peroxide of hydrogen, cleansing it thoroughly as often as I dared, for all surgeons will testify that wounds can be washed and disturbed too frequently.  The strong antiseptics used too often will cut down healthy granulations. After thorough cleansing I dressed them with aristol and bichloride gauze.  This was done once every day, often twice. The awful stench complained of was not so much from the discharge of the wound as from the effete material which saturated his bed.  Some of the horrors of this stench might have been allayed by the judicious use of disinfectants. When Dr. Overton made his complaint to me of the odor from this ward, I immediately used carbolic acid freely on my patient's bed and sprinkled it on the floor of the ward.  But it seems to me that the duty of disinfecting the City hospital would devolve upon the authorities of said hospital, and that they should not endeavor to shoulder upon a visiting surgeon the evil effects resulting from this sad neglect of so important a matter.  That kind of neglect may be borne with patience by the paupers, for whose benefit this structure, with its appointment is set apart; and even the delicate nostrils of the city physicians may become accustomed to bad odors in time, but my duty to my patients and to my company, made it imperative that I should complain, and the earnest discharge of this duty has brought down upon me the condemnation of the city authorities. The board of public works has "demanded my dismissal."  I in turn demand of the board of public works that they select a body of reputable surgeons, and have my management of these cases subjected to their careful scrutiny, I am willing to abide by their decision. I had not the time to subject these cases to the inspection of other surgeons to-day.  I hope to publish their opinions to-morrow. Below I append the certificate of Dr. Ben B. Cates, who saw me dress the wound on Tuesday last, before I had any intimation of the action of the board of public works. [Signed] James R. Thomas To Whom It May Concern:  This is to certify that I visited the city hospital in company with Dr. Thomas on yesterday and saw him dress the wound on the negro, Henry Hearn, who had sustained any injury on the E. T. V. & G. railroad and can testify he used all necessary precautions as to antiseptics, &c., in regard the dressing applied. Ben B. Cates Source:  Knoxville Daily Journal and Tribune, August 25, 1892, page 5   The Kid Council.  ... That Hospital Investigation ... The appearance in the city council chamber last night of representatives from the councils of West and North Knoxville and also from the chamber of commerce gave promise of a long, if not interesting, meeting, of the kid council. ... The Hospital Investigation The hospital committee then reported.  Chairman Jarnagin said in his report that one of the injured railroad negroes in the hospital said that he had recently felt something crawling in his wound and that when the bandage was removed magots [sic] fell from it.  The committee recommended the employment of competent physicians to thoroughly examine this patient, and committee was of the opinion that the railroad should have a nurse to look after its patients and regarded the amount ($5) paid the city for the reception of patients, as too small.  As to Dr. Thomas, the railroad physician, he wouldn't or couldn't attend the investigation made by the committee.  The committee felt that the negro in question had been neglected by the attending railroad physician, as he was not in the condition he would have been if he had received proper attention.  As to the city's patients, they were all right and the hospital clean.  The committee complained because it had not the power to enforce the attendance of witnesses at the examination and asked for a further investigation.  The report was accepted and ordered spread on the minutes.  By motion the hospital committee was instructed to continue its investigations and to employ competent physicians to assist in the same, and given power to enforce the attendance of witnesses.  Alderman Callahan said the matter should receive a thorough investigation and that if the railroad was not paying enough for its patients it should be made do so or remove them. Source:  Knoxville Daily Journal and Tribune, August 27, 1892, page 5

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