Physician Joseph Price, who figures prominently in our article on the Garretson Hospital, wrote an article in 1889 documenting 500 deliveries at the Preston Retreat without a single case of septicemia or death. Another reason may be favorable patient selection, since patients required "testimonials" before admission, and those without presumably went to the Blockley Almshouse in West Philadelphia, which opened its massive new facility in 1835 (the future Philadelphia General Hospital, and then the site of CHOP). The Preston Retreat had regulations that prevented the training of medical students there, which may have been one reason for the lower infection rate. The notion that doctors might be spreading disease did not sit well with doctors, and attention to the advice of Holmes and Semmelweis was not widespread until the 1860s, when Louis Pasteur showed a biologic mechanism for transmission of infectious disease via germs, and Joseph Lister showed a way to make instruments and procedures more antiseptic via using carbolic acid sprays. At this time germ theory was not generally known. He recommended, in addition to Holmes' advice, that doctors wash their hands in a bleach solution before assisting in deliveries. In 1847, Ignaz Semmelweis, a Hungarian obstetrician, noted that women who delivered at home or in a hospital with midwives had a much lower risk of infection than mothers delivering in a hospital with physicians and medical students. In it he suggested that physicians themselves were transferring the infection between patients, and recommended avoiding assistance at childbirth immediately after performing an autopsy. In 1843 Oliver Wendell Holmes Sr., the father of the future US Supreme Court justice, published his monograph The Contagiousness of Puerperal Fever. For example, in 1854 an outbreak of childbed fever closed the maternity hospital at Pennsylvania Hospital on Spruce Street. Throughout the world, maternal mortality was dreadful, in large part due to infection, until the latter half of the 19th century. The Retreat had a deserved reputation for a low infection rate and mortality. William Goodell, it admitted pregnant women 16 days before their due date, offering clean clothes, good meals, and two baths per week. The wealthy had the privilege of delivering in their own homes. Andrews Catholic Lithuanian Church today) the Gynecean Hospital for gynecology care at 18th and Vine (now the Holy Family Center annex to the Cathedral) the Indigent Widows and Single Women's Society and adjacent orphanage at 19th and Cherry (now the Logan Hotel) and the Magdalen Society of Philadelphia, an "institution for the shelter and reformation of fallen women," at the northeast corner of 21st and Race (on land now part of The Franklin Institute). Not to be outdone in spirit if not in dollar amount, in 1836 Preston left $250,000 (today $6 million) to the State for the construction and maintenance of a lying-in hospital for indigent married women of good character. Per his will: "The persons to be admitted shall be married women of good character, and in indigent circumstances, who are near the time of their confinement and at the time of application shall be resident in the city or county of Philadelphia or county of Delaware, and shall produce satisfactory testimonials of character." The location chosen may seem a bit out of the way, but in this area in the 1800s there were several centers of women's care: the City Hospital for general care at 19th and Wallace (site of St. Apparently philanthropy was in vogue in the early 1830s, with Stephen Girard in 1831 leaving the City of Philadelphia $6 million (inflation adjusted $140 million today) to fund a private K-12 boarding school for poor white male orphans. This lying-in hospital was funded by the estate of Jonas Preston, a Philadelphia physician, politician, and philanthropist. These columns are the remnants of the Preston Retreat, a maternity hospital which began construction in 1837, functioned as a foster home from 1840 to 1865, and finally opened for maternity services in 1866.
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