産業革命期イギリス工業都市の疾病 : リーズ篤志総合病院入退院台帳 (一八一五-一八一七年) の分析 (近代史のゆくえ)
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This paper is an analysis of urban morbidity in early nineteenth-century England on the basis of hospital records. The main evidence is taken from the admission and discharge registers of the General Infirmary at Leeds, founded in 1767 as a voluntary hospital, which survive for the period from 22 Sept. 1815 to 16 Dec. 1817. Other sources used are the annual reports of the state of the Infirmary, 1767-1852, and the case histories of medicine and surgery, 1763-1809, compiled by William Hey, surgeon and a founder of the Infirmary. During the period covered by the registers, 5,870 in-and-out patients were admitted. Their ages, place of residence, sponsors, diseases of symptoms, type of treatment(whether operated on or nor), length of morbidity, and reasons for leaving the hospital, etc. have been computer-tabulated. The following are some of the important findings: (1) of all the patients, 52.4% came from within the town of Leeds, followed by those from the West Riding of Yorkshire, outside the parish of Leeds(22.1%), and those from the industrial out-townships within the parish(17.5%). Patients from the agricultural out-townships in the parish account for only 1.3%. (2) The annual reports make it clear that a peak in patients numbers was reached the 1820s. This was presumably brought about by the rapid urbanisation of the in-town. The average cure rates were 46.3% for the in-patients, and 53.2% for the out-patients throughout the period, while the hospital mortality rate declined from about 4% to 1.9% by the end of the eighteenth century, yet showed rather a sharp rise to nearly 7% from the late 1840s. This seems to have been mainly due to the increase in operations performed after the adoption fo anesthesia in 1847, which led to a rise in hospital infections. (3) From the age distribution of the patients, it seems that by the beginning of the nineteenth century the Infirmary had become a centre for industrial injuries and emergency cases as a result of the process industrialisation and urbanisation around the area. The highest proportion of patients fall in the young age group of 10-14 for males and 15-19 for females, which corresponds quite closely to the ages of factory workers employed by textile industries of woollen, worsted, and flax-spinning industries in the Leeds area. This is supported by other evidence, the age structure of the patients with surgical diseases. (4) Differences were found between patients from urban and rural areas in various indices such as disease, mean age, proportion of the population of 'hospital-goers', length of treatment & morbidity, operaton & cure rates, probability of dying, and reasons for leaving the Infirmary. These seem to be accounted for by differences in distances to and from the Infirmary, morbidity, availability of sponsors, as well as in attitudes toward going to hospital for treatment.
- 社会経済史学会の論文
- 1993-05-25
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