Doctor describes cases at Philadelphia Hospital to his M.D. Father


Date Written

May 8, 1843

Member of Series

George Nathan Burwell was 23 years old when this was written.
The recipient, Bryant Burwell, was 46 when it was received.

George Nathan Burwell died 48 years, 7 days after writing this.
It was written 180 years, 4 months, 25 days ago.
It was a Monday.

Philadelphia Monday Morning
May 8, 1843

My dear Father,

I suppose you are anxiously waiting for a letter from me, and I am sorry I did not write yesterday afternoon for you would then have received it one day earlier than at present. I put if off until evening however, and then found myself otherwise engaged. Mr. Haywood has without doubt informed you how we arrived at New York, and of my departure for Philadelphia on the clear pleasant morning of Saturday. We reached this city a little before three o’clock that afternoon, and at 3 ½ o’clock I was with my trunk at this great hospital—pretty rapid travelling. By the time I arrived here my cold & hoarseness had almost entirely disappeared as indicated to you by the paper I sent with all the four corners torn off. I have since had some renewal of it—and the reason I could not account for until Friday last. The old flannel shirts I took off (& had been accustomed to wear) very thick from shrinking up & fitted me almost as tightly as my skin. These I had thrown off & put on a new one very loose & thin. I yesterday morning put on another one and have two on now and I felt the benefit of it immediately and am decidedly better this morning. The weather has been quite disagreeable & cold except for a couple of days, ever since I returned. Yesterday was quite warm. We had a thundershower in the afternoon. The prospect from in front of the hospital after it was one of the most beautiful I have ever seen. I can not describe it to you.

The trees are putting out their leaves very fully—their fields are very green & the birds very musical and we are in the midst of all of it. It is [a] beautiful situation I assure you—but the very center part of the beauty & harmony of nature—This is the veriest den of misery and vice I have ever been in. For instance, in the white obstetrical ward, of 29 women on its register, 24 are single. Dr. Tabb & myself attended two cases on Friday & Saturday. Both were young, single women with their first child. The latter proved to be very interesting from the uterus coming down [?] the child the [?] being undulated & which it caused it to be a case of lingering labor. The 2nd stage lasted about 19 hours.

The wards I am in are the following: The white and black women’s surgical (4 ward), the women’s white & black venereal (2 wards)—You see we have not a man under our charge.

We have not many very interesting cases at present in our wards. There are a number of children sick and as summer comes in there will be more—we examined, Park Waters, an interesting case of a child aged 6 years who died from the irritation caused by a congenital scrotal hernia of the right side. It had been constantly sick & in pain for over four months and came under our care a week ago. We could not do much but keep its bowels in order as far as possible & to relieve the tympanitis & support the hernia by a bag truss—for it could not be kept reduced. On opening the sac, we found in it the lower two inches of the ileum, the caecum (cupisn celi) couple inches of the colon. There were no adhesions or strangulation, but the peritoneal portion of the sac (tunica vaginalis) was inflamed with the formation of some pus—the ileum included in the sac was also infected. The head of the rectum and the lower end of the colon were very much contracted, thickened, & the follicles also thickened & very prominent, no infection—the other parts of the abdomen were healthy.

There are 45 children in the two nurseries & 33 women, all of whom come under our charge whenever they get sick. Among the children, now under treatment, there is a case of varicella, one of et. Hydrocephalus (in which the sagittal, corneal, & part of the Lambdoidal sutures are open & of course the aut. farct.), one with a bad cold & bowel complaints, one with a large & copious abscess of the neck, and three or four with bowel complaints. There is no puerperal fever in the house now. If any occurs it will come under our care. There have been five women confirmed in the last week.

In the surgical wards there are a number of cases of ulcers—a number of vaginal & uterine disease—of burns, lameness, etc. There are a couple of cases of interesting eye disease, one of granular ophthalmia & one of acute purulent ophthalmia (which I have never before seen). I am consulted generally in the cases of eye disease all over the house.

The number of sick here is less than has been for years—or in the case of all the hospitals in the city. Probably on account of the progress of temperance. I will give you more practice statistics in my next.

Affectionately yours,
George N. Burwell

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