In spite of token efforts to make hospitals cleaner, most remained overcrowded, grimy, and poorly managed. They were breeding grounds for infection and provided only the most primitive facilities for the sick and the dying, many of whom were housed on wards with little ventilation or access to clean water. Surgical incisions made in large city hospitals were so vulnerable to infection that operations were restricted to only the most urgent cases. The sick often languished in filth for long periods before they received medical attention, because most hospitals were disastrously understaffed. In
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