Developing A Unified Patientrecord A Practical
Guide Thompson download
https://ebookbell.com/product/developing-a-unified-patientrecord-
a-practical-guide-thompson-10503072
Explore and download more ebooks at ebookbell.com
Here are some recommended products that we believe you will be
interested in. You can click the link to download.
Evolutionary Case Formulation Developing A Unified Language For The
Practice Of Psychotherapy
https://ebookbell.com/product/evolutionary-case-formulation-
developing-a-unified-language-for-the-practice-of-
psychotherapy-61176536
Beyond Bios Developing With The Unified Extensible Firmware Interface
Third Edition 3rd Ed Vincent Zimmer Michael Rothman Suresh Marisetty
https://ebookbell.com/product/beyond-bios-developing-with-the-unified-
extensible-firmware-interface-third-edition-3rd-ed-vincent-zimmer-
michael-rothman-suresh-marisetty-51027326
Beyond Bios Developing With The Unified Extensible Firmware Interface
3rd Edition Vincent Zimmer
https://ebookbell.com/product/beyond-bios-developing-with-the-unified-
extensible-firmware-interface-3rd-edition-vincent-zimmer-10562264
Developing A Path To Data Dominance Strategies For Digital Datacentric
Enterprises Arthur Langer
https://ebookbell.com/product/developing-a-path-to-data-dominance-
strategies-for-digital-datacentric-enterprises-arthur-langer-49602038
Developing A Sport Psychology Consultancy Practice A Toolkit For
Students And Trainees 1st Edition Vaithehy Shanmuganathanfelton
https://ebookbell.com/product/developing-a-sport-psychology-
consultancy-practice-a-toolkit-for-students-and-trainees-1st-edition-
vaithehy-shanmuganathanfelton-50287076
Developing A Winning Grant Proposal Donald C Orlich Nancy R Shrope
https://ebookbell.com/product/developing-a-winning-grant-proposal-
donald-c-orlich-nancy-r-shrope-51241714
Developing A Transformation Agenda For Zimbabwe 1st Edition Shari
Eppel Brian Raftopoulos
https://ebookbell.com/product/developing-a-transformation-agenda-for-
zimbabwe-1st-edition-shari-eppel-brian-raftopoulos-51254348
Developing A Sustainable Economy In Cameroon 1st Edition Ajab Amin
https://ebookbell.com/product/developing-a-sustainable-economy-in-
cameroon-1st-edition-ajab-amin-51255184
Developing A Robust And Responsive Esociety Janice Burn Sue Stoney
https://ebookbell.com/product/developing-a-robust-and-responsive-
esociety-janice-burn-sue-stoney-51335498
Developing A Unified Patientrecord A Practical Guide Thompson
Developing A Unified Patientrecord A Practical Guide Thompson
Developing a
Unified Patient
Record
A practical guide
Deb Thompson
EN, RGN, Dip HE
Senior Nurse for Tissue Viability and Practice Development
Weston Area Health NHS Trust, Somerset
and
Kim Wright
RGN, BSc (Hons) Nursing Studies, MSc Health Informatics
Nursing and Midwifery Informatician
North Bristol NHS Trust
Foreword by
Yvonne Baker and Tricia Woodhead
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
First published 2003 by Radcliffe Publishing
Published 2018 by CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2003 Deb Thompson and Kim Wright
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
ISBN-13: 978-1-85775-939-6 (pbk)
This book contains information obtained from authentic and highly regarded sources.
While all reasonable efforts have been made to publish reliable data and information,
neither the author[s] nor the publisher can accept any legal responsibility or liability for
any errors or omissions that may be made. The publishers wish to make clear that any
views or opinions expressed in this book by individual editors, authors or contributors
are personal to them and do not necessarily reflect the views/opinions of the publishers.
The information or guidance contained in this book is intended for use by medical,
scientific or health-care professionals and is provided strictly as a supplement to the
medical or other professional's own judgement, their knowledge of the patient's medical
history, relevant manufacturer's instructions and the appropriate best practice
guidelines. Because of the rapid advances in medical science, any information or advice
on dosages, procedures or diagnoses should be independently verified. The reader is
strongly urged to consult the relevant national drug formulary and the drug companies'
and device or material manufacturers' printed instructions, and their websites, before
administering or utilizing any of the drugs, devices or materials mentioned in this book.
This book does not indicate whether a particular treatment is appropriate or suitable for
a particular individual. Ultimately it is the sole responsibility of the medical
professional to make his or her own professional judgements, so as to advise and treat
patients appropriately. The authors and publishers have also attempted to trace the
copyright holders of all material reproduced in this publication and apologize to
copyright holders if permission to publish in this form has not been obtained. If any
copyright material has not been acknowledged please write and let us know so we may
rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted,
reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other
means, now known or hereafter invented, including photocopying, microfilming, and
recording, or in any information storage or retrieval system, without written permission
from the publishers.
Trademark Notice: Product or corporate names may be trademarks or registered
trademarks, and are used only for identification and explanation without intent to
infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library.
Typeset by Acom Bookwork, Salisbury, Wiltshire
Contents
Foreword vi
Preface viii
About the authors ix
About this book x
Acknowledgements xi
1 Introduction 1
History and context 1
Integrated care pathways (ICPs) 3
The elements of a traditional paper record 4
2 What is a unified patient record? 11
Definition of a unified patient record 12
Multidisciplinary collaboration 12
Elements of the unified patient record 13
Benefits of a unified patient record 30
Finally... 32
3 The use of evidence-based practice within a unified patient
record 33
Evidence-based practice 33
Care guides 35
Finally... 38
4 The link between record keeping and an EPR 41
Clinical language issues 42
Structure of clinical information needed for EPR 44
iv • Contents
Converting a paper framework into EPR via procurement
specification 45
Decision support/evidence into practice 47
Finally... 47
5 Uses of the information within a patient record 49
Clinical governance 52
An example of improved information practice 53
Answering complaints 54
Using UPR information to improve referrals 56
Finally... 56
6 Managing change 59
Characteristics of change 59
Culture change within the clinical professions 61
The context of change 63
Strategies to support change 67
Raising awareness 67
Process mapping 68
Sustaining change 68
National initiatives to promote change 69
Coping with restraints 69
Recommendations 70
Finally... 72
7 Frequently asked questions 75
8 Toolkit for the development of a unified patient record 79
How to start the process of change 79
How to establish a baseline 80
How to develop a framework for collecting information 80
How to use existing integrated care pathways 81
How to develop evidence-based care guides 81
How to make arrangements to use the Gloucester Patient Profile 82
How to do a pilot, and learn from it 82
How to prepare for rollout 85
Things to expect during the project 93
How to maintain the momentum of the project 94
How to provide ongoing training 95
Finally... 95
9 Example of a unified patient record 97
Gloucester Patient Profile 98
Contents • v
Weston Area Health Trust patient record 102
Care guides 112
Unified specialist assessments andrecords 120
Glossary of terms 131
Further reading 135
Index 137
Foreword
High quality, shared record keeping is recognised as being fundamentally
important to good patient care. There is plenty of evidence about how
vital it is, for example in Learning from Bristol1 and An Organisation with a
Memory,2 as well as it being a consistent theme in Information for 3
and all the subsequent strategy documents around health informatics. It is
one of the ways we get over the need for professional specialisation whilst
taking account of the patient's needs in a holistic manner.
It is very easy to assume that these improvements can only take place
when technology is available to support it, but Deb and Kim prove that it
is not so much the availability of electronic systems that is key to
progress, but cultural change, especially in relation to clinical informatics
practice. Quite simply, before technology can help us we need to know
what we want to achieve from it. It was this belief that led Weston Area
Health NHS Trust and Avon IM&T Consortium to support the New
Patient Record project.
This book offers an excellent practical approach to addressing the
changes needed in clinical record keeping to support improved patient
care, clinical governance, better management information and the move
towards electronic patient records (EPRs). It brings together a strong
clinical focus with the informatics principles needed to support a
successful move to modem record keeping. Using simple tools, Deb and
Kim have led the development of a clinical information culture at Weston.
These sorts of improvement could be achieved elsewhere as long as there
is the will and drive to change.
It is important never to underestimate the challenges of implementing
change. This is especially so in clinical practice. Clinical practice is forever
changing and healthcare professionals rely on traditional methods of
recording patient details to provide consistency. This consistent approach
Foreword • vii
provides an anchor in a challenging world. To change such a fundamental
task as record keeping without diminishing patient care takes time,
reassurance, education and support. Making sense of change is a key
component to successful implementation. Ways of helping staff to make
sense of change are fundamental tools of a successful change agent. Deb
and Kim provide details of a toolbox and route map to others wishing to
take the same progressive step.
This approach is already starting to be adopted locally in other organ­
isations as part of the implementation of electronic records. It has also
served as a beacon to other staff groups needing to change their record
keeping in preparation for the EPR. From an informatics perspective, we
see this work as a vital part of the implementation of electronic records
and, ultimately, integrated care records as outlined in Delivering 21st
Century IT Support for the NHSf We both hope that other communities
will be enthused by the practicality and patient focus of what Deb and
Kim have done in their hospitals, and feel inspired to do the same.
Yvonne Baker Tricia Woodhead
Divisional Head, Project Management Director of Medicine
Avon IM&T Consortium Weston Area Health NHS Trust
January 2003
References
1 Department of Health (2002) Learning from Bristol. The Department of Health
response to the report of the public inquiry into children's heart surgery at the
Bristol Royal Infirmary 1984^-1995. HMSO, London.
2 Department of Health (2002) An Organisation with a Memory. Report of an
expert group on learningfrom adverse events in the NHS. HMSO, London.
3 Bums F (1998) Information for Health. An information strategy for the modern
NHS, 1998-2005. Department of Health Publications, Wetherby.
4 NHS Executive (2002) Delivering 21st Century IT Supportfor the NHS. HMSO,
London.
Preface
Kim and I first worked together on a surgical ward in the early 90s and
shared common interests in standard setting, documentation and
improving patient care. In 1998, Kim led the development of integrated
care pathways at Weston. As a junior sister, I first became involved in
trustwide record-keeping issues when she became a member of the Stroke
Pathway Group. It was through the work of this group that we both
developed an insight into the need for a modem framework for collecting
clinical information to prepare for electronic patient records.
This inspired the idea for developing a new multidisciplinary system
for record keeping, which was facilitated by Kim, and run on the ward
that I managed.
I continue to lead clinical record-keeping developments at Weston,
whilst Kim has been involved in culture change issues within the Avon
IM&T Consortium. The mix of nursing experience and clinical informatics
expertise has enabled us to be at the cutting edge of the information
agenda in clinical practice.
We wrote this book to help others understand the importance of unified
record keeping as an integral part of patient care, and the advantages of
designing records in such a way that aggregated clinical information can
be easily extracted. Please read and enjoy.
Deb Thompson
Kim Wright
January 2003
About the authors
Deb Thompson e n , r g n , Dip h e is Senior Nurse for Tissue Viability and
Practice Development at Weston Area Health NHS Trust in Somerset. She
has worked as a nurse within the NHS for 23 years.
Kim Wright RGN, BSc (Hons) Nursing Studies, MSc Health Informatics is 3 Nursing and
Midwifery Informatician at North Bristol NHS Trust. She worked as a
ward nurse for 15 years, before spending the last seven years in the NHS
in clinical audit, clinical governance and health informatics.
About this book
This practical guide is intended for use by all clinicians and those who
deal with clinical information. The book's aims are as follows.
• To put into context the need for a change in the way clinical profes­
sionals collect, record, store and use clinical information about patients
in acute settings, such as hospitals, with particular reference to the
principles within Information for Health, the current NHS information
strategy.
• To show how clinical governance, including risk management and
evidence-based practice, can be more easily addressed by modernising
clinical information practice.
• To help those involved in electronic patient record (EPR) procurement
to develop a framework for recording care and treatment, which is
suitable for transposing to EPR systems.
• To give practical examples of the design and implementation of a
unified multidisciplinary patient record.
• To demonstrate how a clinical record can be streamlined to enable
management information to be extracted as a by-product of informa­
tion recorded at the point of care, as part of the care process.
Acknowledgements
We would like to acknowledge the following organisations and people.
The staff and patients of Weston Area Health NHS Trust, Somerset, for
their tolerance and participation in the ongoing evolution of record­
keeping practice. Particular thanks go to the staff of Bimbeck Ward and
the documentation link nurses.
The clinical governance department at Gloucester Royal Infirmary,
namely Graham Hodgson and Cheryl Haswell, for allowing us to use and
build upon the Gloucester Patient Profile.
Our families, for putting up with our utter distraction from normal life
during the writing of this book.
Developing A Unified Patientrecord A Practical Guide Thompson
Introduction
History and context
This chapter summarises the evolution of clinical records over the last
century, up to the present day, and introduces the concept of change
required to modernise record keeping in preparation for an electronic
solution.
The written healthcare record has a long history, stemming from the
days of Florence Nightingale, and the efforts of doctors to transfer
thinking to paper.1 The creation of the Lloyd-George folder in the 1920s,
still in use by GPs, was the start of the recording of medical information.
The use of case notes in hospitals started as an aide-memoire for doctors,
but has become increasingly complex, multi-dimensional and tied up in
bureaucracy.
Within nursing, research shows a tension between the profession­
alism of using a model of care such as Roper2 to express nurs­
ing work, and the reality of workplace record keeping on the wards.3
Things have changed since nursing models were introduced, managers
now use documentation as a quality assurance mechanism, and all profes­
sions are judged by the quality of care. Standards of care are central to the
NHS modernisation agenda.4
The Audit Commission5 showed that 25% of clinical time is spent on
record keeping, most of which is repetitive. The pressure to document
properly to defend against litigation means that records have become
little more than an elaborate accounting mechanism.3 Nurses in particular
1
2 • Developing a unified patient record
are being forced to give more attention to record keeping than to nursing
care.
Information for Health,6 the government's strategy to introduce informa­
tion and information technology (IT) to the NHS, places importance on
the need for accurate, concise, person-based information in the context of
the electronic patient record (EPR). The NHS Plan and Building the Informa­
tion Core merge to give more concrete guidance about how to achieve it.
For example:
'information systems will need to support health care professionals in
addressing the requirements of the earlier modernisation agenda by effective
clinical audit information as a by-product of patient care.'
NHS Executive4'7
During the mid 1990s, the Audit Commission looked into the status of
hospital and community patient records and drew conclusions about the
information within them, the way they were structured, used and stored,
and the future.5,8 One of the main conclusions of the hospital study was
that:
'before technology can be used effectively, hospitals need to improve their
manual systems.'
Setting the Records Straight (p57)8
In order for the impact of the impending EPR to be less disruptive, the
change in recording to achieve this needs to happen on paper first. We
believe that the structure and content of a unified paper record is linked
strongly to the successful implementation and use of an EPR.
Assessment is the key to care.9 The nature of record keeping for each
profession is that of individual assessment and free text recording of treat­
ment and care. Unfortunately, each profession undertakes separate assess­
ments, which can be tediously repetitive for the patient/carers. Within
comprehensive, unified and timely assessment, routine and repetitive care
can be recorded quickly and easily, with attention paid to what is special
about the patient, known as 'documentation by exception'.
Integrated care pathways (ICPs) are also central to the modernisation
agenda and Information for Health - they allow systematic audit,
documentation by exception and standardisation of information. In
addition, the pathway development process allows all disciplines
involved with the patient, from receptionist to clinical coder and clinical
professional, to examine processes of care together with the patient at
the centre.
Introduction • 3
In recent years we have recognised that documentation carries a large
amount of risk, because of the following.
• Communication between professions is fragmented due to the major
differences between the documentation they use. This is compounded
by the fact that notes are kept in several different places.
• Nursing care plans are notoriously hard to decipher and because they
are time-consuming to complete, the information within them is often
of poor quality. Specialist staff often have to duplicate information in
two or three different sets of notes to ensure adequate communication.
• In order to follow through an episode of care, for example to answer a
complaint, it is necessary to leaf through several different sections of
the notes to gain information from the same time period.
• The medical record itself usually includes pages of paper on which is
written one sentence, or a page for a risk assessment where the assess­
ment is carried out once during an admission.
• Along with spare sheets filed unnecessarily and an abundance of
single fluid charts, the bulk of the notes is increased, contributing to
storage and handling problems.
In the late 1990s, the promise of a technological solution to the problems
caused by the complexity and inconvenience of paper records was on the
horizon. In 1998 the NHS Information Policy Unit (NHSIPU) stated that:
'training, cultural changes and improved ways of working are active compon­
ents in an information-enabled NHS.'
Working Together with Health Information10
Clinical practice at the time was focused on ways of working that did not
match the working practices needed to make full use of an EPR.
Integrated care pathways
The National Pathways Association11 describe an integrated care pathway
(ICP) as a tool that:
'determines locally agreed, multidisciplinary practice based on guidelines
and evidence where available, for a specific patient/client group. It forms all
or part of the clinical record, documents the care given and facilitates the
evaluation of outcomes for continuous monitoring.'
Developing Care Pathways11
Other documents randomly have
different content
pattern. Darwin already had pointed to the act of fertilization as the
determining point, and it is in this direction that the theory of
hybridism has made the greatest advance.
The starting-point of the modern views comes from the
experiments and conclusions on plant hybrids made by Gregor
Mendel and published in 1865. It is uncertain if Darwin had paid
attention to this work; Romanes, writing in the 9th edition of this
Encyclopaedia, cited it without comment. First H. de Vries, then W.
Bateson and a series of observers returned to the work of Mendel
(see Mendelism), and made it the foundation of much experimental
work and still more theory. It is still too soon to decide if the
confident predictions of the Mendelians are justified, but it seems
clear that a combination of Mendel’s numerical results with
Weismann’s (see Heredity) conception of the particulate character of
the germ-plasm, or hereditary material, is at the root of the
phenomena of hybridism, and that Darwin was justified in supposing
it to lie outside the sphere of natural selection and to be a
fundamental fact of living matter.
Authorities.—Apellö, “Über einige Resultate der Kreuzbefruchtung
bei Knochenfischen,” Bergens mus. aarbog (1894); Bateson,
“Hybridization and Cross-breeding,” Journal of the Royal Horticultural
Society (1900); J. L. Bonhote, “Hybrid Ducks,” Proc. Zool. Soc. of
London (1905), p. 147; Boveri, article “Befruchtung,” in Ergebnisse
der Anatomie und Entwickelungsgeschichte von Merkel und Bonnet, i.
385-485; Cornevin et Lesbre, “Étude sur un hybride issu d’une mule
féconde et d’un cheval,” Rev. Sci. li. 144; Charles Darwin, Origin of
Species (1859), The Effects of Cross and Self-Fertilization in the
Vegetable Kingdom (1878); Delage, La Structure du protoplasma et
les théories sur l’hérédité (1895, with a literature); de Vries, “The Law
of Disjunction of Hybrids,” Comptes rendus (1900), p. 845; Elliot,
Hybridism; Escherick, “Die biologische Bedeutung der Genitalabhänge
der Insecten,” Verh. z. B. Wien, xlii. 225; Ewart, The Penycuik
Experiments (1899); Focke, Die Pflanzen-Mischlinge (1881); Foster-
Melliar, The Book of the Rose (1894); C. F. Gaertner, various papers in
Flora, 1828, 1831, 1832, 1833, 1836, 1847, on “Bastard-Pflanzen”;
Gebhardt, “Über die Bastardirung von Rana esculenta mit R. arvalis,”
Inaug. Dissert. (Breslau, 1894); G. Mendel, “Versuche über Pflanzen-
Hybriden,” Verh. Natur. Vereins in Brünn (1865), pp. 1-52; Morgan,
“Experimental Studies,” Anat. Anz. (1893), p. 141; id. p. 803; G. J.
Romanes, “Physiological Selection,” Jour. Linn. Soc. xix. 337; H.
Scherren, “Notes on Hybrid Bears,” Proc. Zool. Soc. of London (1907),
p. 431; Saunders, Proc. Roy. Soc. (1897), lxii. 11; Standfuss, “Études
de zoologie expérimentale,” Arch. Sci. Nat. vi. 495; Suchetet, “Les
Oiseaux hybrides rencontrés à l’état sauvage,” Mém. Soc. Zool. v.
253-525, and vi. 26-45; Vernon, “The Relation between the Hybrid
and Parent Forms of Echinoid Larvae,” Proc. Roy. Soc. lxv. 350;
Wallace, Darwinism (1889); Weismann, The Germ-Plasm (1893).
(P. C. M)
HYDANTOIN (glycolyl urea), C3H4N2O2 or the
ureïde of glycollic acid, may be obtained by heating allantoin or
alloxan with hydriodic acid, or by heating bromacetyl urea with
alcoholic ammonia. It crystallizes in needles, melting at 216° C.
When hydrolysed with baryta water yields hydantoic
(glycoluric)acid, H2N·CO·NH·CH2·CO2H, which is readily soluble in hot
water, and on heating with hydriodic acid decomposes into ammonia,
carbon dioxide and glycocoll, CH2·NH2·CO2·H. Many substituted
hydantoins are known; the α-alkyl hydantoins are formed on fusion of
aldehyde- or ketone-cyanhydrins with urea, the β-alkyl hydantoins
from the fusion of mono-alkyl glycocolls with urea, and the γ-alkyl
hydantoins from the action of alkalis and alkyl iodides on the α-
compounds. γ-Methyl hydantoin has been obtained as a splitting
product of caffeine (E. Fischer, Ann., 1882, 215, p. 253).
HYDE, the name of an English family distinguished in the 17th
century. Robert Hyde of Norbury, Cheshire, had several sons, of
whom the third was Lawrence Hyde of Gussage St Michael,
Dorsetshire. Lawrence’s son Henry was father of Edward Hyde, earl of
Clarendon (q.v.), whose second son by his second wife was
Lawrence, earl of Rochester (q.v.); another son was Sir Lawrence
Hyde, attorney-general to Anne of Denmark, James I.’s consort; and a
third son was Sir Nicholas Hyde (d. 1631), chief-justice of England.
Sir Nicholas entered parliament in 1601 and soon became prominent
as an opponent of the court, though he does not appear to have
distinguished himself in the law. Before long, however, he deserted
the popular party, and in 1626 he was employed by the duke of
Buckingham in his defence to impeachment by the Commons; and in
the following year he was appointed chief-justice of the king’s bench,
in which office it fell to him to give judgment in the celebrated case
of Sir Thomas Darnell and others who had been committed to prison
on warrants signed by members of the privy council, which contained
no statement of the nature of the charge against the prisoners. In
answer to the writ of habeas corpus the attorney-general relied on
the prerogative of the crown, supported by a precedent of Queen
Elizabeth’s reign. Hyde, three other judges concurring, decided in
favour of the crown, but without going so far as to declare the right
of the crown to refuse indefinitely to show cause against the
discharge of the prisoners. In 1629 Hyde was one of the judges who
condemned Eliot, Holles and Valentine for conspiracy in parliament to
resist the king’s orders; refusing to admit their plea that they could
not be called upon to answer out of parliament for acts done in
parliament. Sir Nicholas Hyde died in August 1631.
Sir Lawrence Hyde, attorney-general to Anne of Denmark, had
eleven sons, four of whom were men of some mark. Henry was an
ardent royalist who accompanied Charles II. to the continent, and
returning to England was beheaded in 1650; Alexander (1598-1667)
became bishop of Salisbury in 1665; Edward (1607-1659) was a
royalist divine who was nominated dean of Windsor in 1658, but died
before taking up the appointment, and who was the author of many
controversial works in Anglican theology; and Robert (1595-1665)
became recorder of Salisbury and represented that borough in the
Long Parliament, in which he professed royalist principles, voting
against the attainder of Strafford. Having been imprisoned and
deprived of his recordership by the parliament in 1645/6, Robert
Hyde gave refuge to Charles II. on his flight from Worcester in 1651,
and on the Restoration he was knighted and made a judge of the
common pleas. He died in 1665. Henry Hyde (1672-1753), only son
of Lawrence, earl of Rochester, became 4th earl of Clarendon and 2nd
earl of Rochester, both of which titles became extinct at his death. He
was in no way distinguished, but his wife Jane Hyde, countess of
Clarendon and Rochester (d. 1725), was a famous beauty celebrated
by the homage of Swift, Prior and Pope, and by the groundless
scandal of Lady Mary Wortley Montagu. Two of her daughters, Jane,
countess of Essex, and Catherine, duchess of Queensberry, were also
famous beauties of the reign of Queen Anne. Her son, Henry Hyde
(1710-1753), known as Viscount Cornbury, was a Tory and Jacobite
member of parliament, and an intimate friend of Bolingbroke, who
addressed to him his Letters on the Study and Use of History, and On
the Spirit of Patriotism. In 1750 Lord Cornbury was created Baron
Hyde of Hindon, but, as he predeceased his father, this title reverted
to the latter and became extinct at his death. Lord Cornbury was
celebrated as a wit and a conversationalist. By his will he bequeathed
the papers of his great-grandfather, Lord Clarendon, the historian, to
the Bodleian Library at Oxford.
See Lord Clarendon, The Life of Edward, Earl of Clarendon (3 vols.,
Oxford, 1827); Edward Foss, The Judges of England (London, 1848-
1864); Anthony à Wood, Athenae oxonienses (London, 1813-1820);
Samuel Pepys, Diary and Correspondence, edited by Lord Braybrooke
(4 vols., London, 1854).
HYDE, THOMAS (1636-1703), English Orientalist, was born at
Billingsley, near Bridgnorth, in Shropshire, on the 29th of June 1636.
He inherited his taste for linguistic studies, and received his first
lessons in some of the Eastern tongues, from his father, who was
rector of the parish. In his sixteenth year Hyde entered King’s
College, Cambridge, where, under Wheelock, professor of Arabic, he
made rapid progress in Oriental languages, so that, after only one
year of residence, he was invited to London to assist Brian Walton in
his edition of the Polyglott Bible. Besides correcting the Arabic, Persic
and Syriac texts for that work, Hyde transcribed into Persic characters
the Persian translation of the Pentateuch, which had been printed in
Hebrew letters at Constantinople in 1546. To this work, which
Archbishop Ussher had thought well-nigh impossible even for a native
of Persia, Hyde appended the Latin version which accompanies it in
the Polyglott. In 1658 he was chosen Hebrew reader at Queen’s
College, Oxford, and in 1659, in consideration of his erudition in
Oriental tongues, he was admitted to the degree of M.A. In the same
year he was appointed under-keeper of the Bodleian Library, and in
1665 librarian-in-chief. Next year he was collated to a prebend at
Salisbury, and in 1673 to the archdeaconry of Gloucester, receiving
the degree of D.D. shortly afterwards. In 1691 the death of Edward
Pococke opened up to Hyde the Laudian professorship of Arabic; and
in 1697, on the deprivation of Roger Altham, he succeeded to the
regius chair of Hebrew and a canonry of Christ Church. Under Charles
II., James II. and William III. Hyde discharged the duties of Eastern
interpreter to the court. Worn out by his unremitting labours, he
resigned his librarianship in 1701, and died at Oxford on the 18th of
February 1703. Hyde, who was one of the first to direct attention to
the vast treasures of Oriental antiquity, was an excellent classical
scholar, and there was hardly an Eastern tongue accessible to
foreigners with which he was not familiar. He had even acquired
Chinese, while his writings are the best testimony to his mastery of
Turkish, Arabic, Syriac, Persian, Hebrew and Malay.
In his chief work, Historia religionis veterum Persarum (1700), he
made the first attempt to correct from Oriental sources the errors of
the Greek and Roman historians who had described the religion of
the ancient Persians. His other writings and translations comprise
Tabulae longitudinum et latitudinum stellarum fixarum ex
observatione principis Ulugh Beighi (1665), to which his notes have
given additional value; Quatuor evangelia et acta apostolorum lingua
Malaica, caracteribus Europaeis (1677); Epistola de mensuris et
ponderibus serum sive sinensium (1688), appended to Bernard’s De
mensuris et ponderibus antiquis; Abraham Peritsol itinera mundi
(1691); and De ludis orientalibus libri II. (1694).
With the exception of the Historia religionis, which was republished
by Hunt and Costard in 1760, the writings of Hyde, including some
unpublished MSS., were collected and printed by Dr Gregory Sharpe
in 1767 under the title Syntagma dissertationum quas olim ... Thomas
Hyde separatim edidit. There is a life of the author prefixed. Hyde
also published a catalogue of the Bodleian Library in 1674.
HYDE, a market town and municipal borough in the Hyde
parliamentary division of Cheshire, England, 71⁄2 m. E. of Manchester,
by the Great Central railway. Pop. (1901) 32,766. It lies in the densely
populated district in the north-east of the county, on the river Tame,
which here forms the boundary of Cheshire with Lancashire. To the
east the outlying hills of the Peak district of Derbyshire rise abruptly.
The town has cotton weaving factories, spinning mills, print-works,
iron foundries and machine works; also manufactures of hats and
margarine. There are extensive coal mines in the vicinity. Hyde is
wholly of modern growth, though it contains a few ancient houses,
such as Newton Hall, in the part of the town so called. The old family
of Hyde held possession of the manor as early as the reign of John.
The borough, incorporated in 1881, is under a mayor, 6 aldermen and
18 councillors. Area, 3081 acres.
HYDE DE NEUVILLE, JEAN GUILLAUME, Baron (1776-1857),
French politician, was born at La Charité-sur-Loire (Nièvre) on the
24th of January 1776, the son of Guillaume Hyde, who belonged to
an English family which had emigrated with the Stuarts after the
rebellion of 1745. He was only seventeen when he successfully
defended a man denounced by Fouché before the revolutionary
tribunal of Nevers. From 1793 onwards he was an active agent of the
exiled princes; he took part in the Royalist rising in Berry in 1796, and
after the coup d’état of the 18th Brumaire (November 9, 1799) tried
to persuade Bonaparte to recall the Bourbons. An accusation of
complicity in the infernal machine conspiracy of 1800-1801 was
speedily retracted, but Hyde de Neuville retired to the United States,
only to return after the Restoration. He was sent by Louis XVIII. to
London to endeavour to persuade the British government to transfer
Napoleon to a remoter and safer place of exile than the isle of Elba,
but the negotiations were cut short by the emperor’s return to France
in March 1815. In January 1816 de Neuville became French
ambassador at Washington, where he negotiated a commercial treaty.
On his return in 1821 he declined the Constantinople embassy, and in
November 1822 was elected deputy for Cosne. Shortly afterwards he
was appointed French ambassador at Lisbon, where his efforts to
oust British influence culminated, in connexion with the coup d’état of
Dom Miguel (April 30, 1824), in his suggestion to the Portuguese
minister to invite the armed intervention of Great Britain. It was
assumed that this would be refused, in view of the loudly proclaimed
British principle of non-intervention, and that France would then be in
a position to undertake a duty that Great Britain had declined. The
scheme broke down, however, owing to the attitude of the
reactionary party in the government of Paris, which disapproved of
the Portuguese constitution. This destroyed his influence at Lisbon,
and he returned to Paris to take his seat in the Chamber of Deputies.
In spite of his pronounced Royalism, he now showed Liberal
tendencies, opposed the policy of Villèle’s cabinet, and in 1828
became a member of the moderate administration of Martignac as
minister of marine. In this capacity he showed active sympathy with
the cause of Greek independence. During the Polignac ministry
(1829-1830) he was again in opposition, being a firm upholder of the
charter; but after the revolution of July 1830 he entered an all but
solitary protest against the exclusion of the legitimate line of the
Bourbons from the throne, and resigned his seat. He died in Paris on
the 28th of May 1857.
His Mémoires et souvenirs (3 vols., 1888), compiled from his notes
by his nieces, the vicomtesse de Bardonnet and the baronne
Laurenceau, are of great interest for the Revolution and the
Restoration.
HYDE PARK, a small township of Norfolk county, Massachusetts,
U.S.A., about 8 m. S.W. of the business centre of Boston. Pop. (1890)
10,193; (1900) 13,244, of whom 3805 were foreign-born; (1910
census) 15,507. Its area is about 41⁄2 sq. m. It is traversed by the
New York, New Haven & Hartford railway, which has large repair
shops here, and by the Neponset river and smaller streams. The
township contains the villages of Hyde Park, Readville (in which there
is the famous “Weil” trotting-track), Fairmount, Hazelwood and
Clarendon Hills. Until about 1856 Hyde Park was a farmstead. The
value of the total factory product increased from $4,383,959 in 1900
to $6,739,307 in 1905, or 53.7%. In 1868 Hyde Park was
incorporated as a township, being formed of territory taken from
Dorchester, Dedham and Milton.
HYDERABAD, or Haidarabad, a city and district of British India, in
the Sind province of Bombay. The city stands on a hill about 3 m.
from the left bank of the Indus, and had a population in 1901 of
69,378. Upon the site of the present fort is supposed to have stood
the ancient town of Nerankot, which in the 8th century submitted to
Mahommed bin Kasim. In 1768 the present city was founded by
Ghulam Shah Kalhora; and it remained the capital of Sind until 1843,
when, after the battle of Meeanee, it was surrendered to the British,
and the capital transferred to Karachi. The city is built on the most
northerly hills of the Ganga range, a site of great natural strength. In
the fort, which covers an area of 36 acres, is the arsenal of the
province, transferred thither from Karachi in 1861, and the palaces of
the ex-mirs of Sind. An excellent water supply is derived from the
Indus. In addition to manufactures of silk, gold and silver embroidery,
lacquered ware and pottery, there are three factories for ginning
cotton. There are three high schools, training colleges for masters
and mistresses, a medical school, an agricultural school for village
officials, and a technical school. The city suffered from plague in
1896-1897.
The District of Hyderabad has an area of 8291 sq. m., with a
population in 1901 of 989,030, showing an increase of 15% in the
decade. It consists of a vast alluvial plain, on the left bank of the
Indus, 216 m. long and 48 broad. Fertile along the course of the river,
it degenerates towards the east into sandy wastes, sparsely
populated, and defying cultivation. The monotony is relieved by the
fringe of forest which marks the course of the river, and by the
avenues of trees that line the irrigation channels branching eastward
from this stream. The south of the district has a special feature in its
large natural water-courses (called dhoras) and basin-like shallows
(chhaus), which retain the rains for a long time. A limestone range
called the Ganga and the pleasant frequency of garden lands break
the monotonous landscape. The principal crops are millets, rice, oil-
seeds, cotton and wheat, which are dependent on irrigation, mostly
from government canals. There is a special manufacture at Hala of
glazed pottery and striped cotton cloth. Three railways traverse the
district: (1) one of the main lines of the North-Western system,
following the Indus valley and crossing the river near Hyderabad; (2)
a broad-gauge branch running south to Badin, which will ultimately
be extended to Bombay; and (3) a metre-gauge line from Hyderabad
city into Rajputana.
HYDERABAD, Haidarabad, also known as the Nizam’s Dominions,
the principal native state of India in extent, population and political
importance; area, 82,698 sq. m.; pop. (1901) 11,141,142, showing a
decrease of 3.4% in the decade; estimated revenue 41⁄2 crores of
Hyderabad rupees (£2,500,000). The state occupies a large portion of
the eastern plateau of the Deccan. It is bounded on the north and
north-east by Berar, on the south and south-east by Madras, and on
the west by Bombay. The country presents much variety of surface
and feature; but it may be broadly divided into two tracts,
distinguished from one another geologically and ethnically, which are
locally known from the languages spoken as Telingana and
Marathwara. In some parts it is mountainous, wooded and
picturesque, in others flat and undulating. The open country includes
lands of all descriptions, including many rich and fertile plains, much
good land not yet brought under cultivation, and numerous tracts too
sterile ever to be cultivated. In the north-west the geological
formations are volcanic, consisting principally of trap, but in some
parts of basalt; in the middle, southern and south-western parts the
country is overlaid with gneissic formations. The territory is well
watered, rivers being numerous, and tanks or artificial pieces of water
abundant, especially in Telingana. The principal rivers are the
Godavari, with its tributaries the Dudna, Manjira and Pranhita; the
Wardha, with its tributary the Penganga; and the Kistna, with its
tributary the Tungabhadra. The climate may be considered in general
good; and as there are no arid bare deserts, hot winds are little felt.
More than half the revenue of the state is derived from the land,
and the development of the country by irrigation and railways has
caused considerable expansion in this revenue, though the rate of
increase in the decade 1891-1901 was retarded by a succession of
unfavourable seasons. The soil is generally fertile, though in some
parts it consists of chilka, a red and gritty mould little fitted for
purposes of agriculture. The principal crops are millets of various
kinds, rice, wheat, oil-seeds, cotton, tobacco, sugar-cane, and fruits
and garden produce in great variety. Silk, known as tussur, the
produce of a wild species of worm, is utilized on a large scale. Lac,
suitable for use as a resin or dye, gums and oils are found in great
quantities. Hides, raw and tanned, are articles of some importance in
commerce. The principal exports are cotton, oil-seeds, country-
clothes and hides; the imports are salt, grain, timber, European piece-
goods and hardware. The mineral wealth of the state consists of coal,
copper, iron, diamonds and gold; but the development of these
resources has not hitherto been very successful. The only coal mine
now worked is the large one at Singareni, with an annual out-turn of
nearly half a million tons. This coal has enabled the nizam’s
guaranteed state railway to be worked so cheaply that it now returns
a handsome profit to the state. It also gives encouragement to much-
needed schemes of railway extension, and to the erection of cotton
presses and of spinning and weaving mills. The Hyderabad-Godavari
railway (opened in 1901) traverses a rich cotton country, and cotton
presses have been erected along the line. The currency of the state is
based on the hali sikka, which contains approximately the same
weight of silver as the British rupee, but its exchange value fell
heavily after 1893, when free coinage ceased in the mint. In 1904,
however, a new coin (the Mahbubia rupee) was minted; the supply
was regulated, and the rate of exchange became about 115 = 100
British rupees. The state suffered from famine during 1900, the total
number of persons in receipt of relief rising to nearly 500,000 in June
of that year. The nizam met the demands for relief with great
liberality.
The nizam of Hyderabad is the principal Mahommedan ruler in
India. The family was founded by Asaf Jah, a distinguished Turkoman
soldier of the emperor Aurangzeb, who in 1713 was appointed
subahdar of the Deccan, with the title of nizam-ul-mulk (regulator of
the state), but eventually threw off the control of the Delhi court.
Azaf Jah’s death in 1748 was followed by an internecine struggle for
the throne among his descendants, in which the British and the
French took part. At one time the French nominee, Salabat Jang,
established himself with the help of Bussy. But finally, in 1761, when
the British had secured their predominance throughout southern
India, Nizam Ali took his place and ruled till 1803. It was he who
confirmed the grant of the Northern Circars in 1766, and joined in the
two wars against Tippoo Sultan in 1792 and 1799. The additions of
territory which he acquired by these wars was afterwards (1800)
ceded to the British, as payment for the subsidiary force which he
had undertaken to maintain. By a later treaty in 1853, the districts
known as Berar were “assigned” to defray the cost of the Hyderabad
contingent. In 1857 when the Mutiny broke out, the attitude of
Hyderabad as the premier native state and the cynosure of the
Mahommedans in India became a matter of extreme importance; but
Afzul-ud-Dowla, the father of the present ruler, and his famous
minister, Sir Salar Jang, remained loyal to the British. An attack on
the residency was repulsed, and the Hyderabad contingent displayed
their loyalty in the field against the rebels. In 1902 by a treaty made
by Lord Curzon, Berar was leased in perpetuity to the British
government, and the Hyderabad contingent was merged in the Indian
army. The nizam Mir Mahbub Ali Khan Bahadur, Asaf Jah, a direct
descendant of the famous nizam-ul-mulk, was born on the 18th of
August 1866. On the death of his father in 1869 he succeeded to the
throne as a minor, and was invested with full powers in 1884. He is
notable as the originator of the Imperial Service Troops, which now
form the contribution of the native chiefs to the defence of India. On
the occasion of the Panjdeh incident in 1885 he made an offer of
money and men, and subsequently on the occasion of Queen
Victoria’s Jubilee in 1887 he offered 20 lakhs (£130,000) annually for
three years for the purpose of frontier defence. It was finally decided
that the native chiefs should maintain small but well-equipped bodies
of infantry and cavalry for imperial defence. For many years past the
Hyderabad finances were in a very unhealthy condition, the
expenditure consistently outran the revenue, and the nobles, who
held their tenure under an obsolete feudal system, vied with each
other in ostentatious extravagance. But in 1902, on the revision of
the Berar agreement, the nizam received 25 lakhs (£167,000) a year
for the rent of Berar, thus substituting a fixed for a fluctuating source
of income, and a British financial adviser was appointed for the
purpose of reorganizing the resources of the state.
See S. H. Bilgrami and C. Willmott, Historical and Descriptive
Sketch of the Nizam’s Dominions (Bombay, 1883-1884).
HYDERABAD or Haidarabad, capital of the above state, is situated
on the right bank of the river Musi, a tributary of the Kistna, with
Golconda to the west, and the residency and its bazaars and the
British cantonment of Secunderabad to the north-east. It is the fourth
largest city in India; pop. (1901) 448,466, including suburbs and
cantonment. The city itself is in shape a parallelogram, with an area
of more than 2 sq. m. It was founded in 1589 by Mahommed Kuli,
fifth of the Kutb Shahi kings, of whose period several important
buildings remain as monuments. The principal of these is the Char
Minar or Four Minarets (1591). The minarets rise from arches facing
the cardinal points, and stand in the centre of the city, with four
roads radiating from their base. The Ashur Khana (1594), a
ceremonial building, the hospital, the Gosha Mahal palace and the
Mecca mosque, a sombre building designed after a mosque at Mecca,
surrounding a paved quadrangle 360 ft. square, were the other
principal buildings of the Kutb Shahi period, though the mosque was
only completed in the time of Aurangzeb. The city proper is
surrounded by a stone wall with thirteen gates, completed in the time
of the first nizam, who made Hyderabad his capital. The suburbs, of
which the most important is Chadarghat, extend over an additional
area of 9 sq. m. There are several fine palaces built by various
nizams, and the British residency is an imposing building in a large
park on the left bank of the Musi, N.E. of the city. The bazaars
surrounding it, and under its jurisdiction, are extremely picturesque
and are thronged with natives from all parts of India. Four bridges
crossed the Musi, the most notable of which was the Purana Pul, of
23 arches, built in 1593. On the 27th and 28th of September 1908,
however, the Musi, swollen by torrential rainfall (during which 15 in.
fell in 36 hours), rose in flood to a height of 12 ft. above the bridges
and swept them away. The damage done was widespread; several
important buildings were involved, including the palace of Salar Jang
and the Victoria zenana hospital, while the beautiful grounds of the
residency were destroyed. A large and densely populated part of the
city was wrecked, and thousands of lives were lost. The principal
educational establishments are the Nizam college (first grade),
engineering, law, medical, normal, industrial and Sanskrit schools,
and a number of schools for Europeans and Eurasians. Hyderabad is
an important centre of general trade, and there is a cotton mill in its
vicinity. The city is supplied with water from two notable works, the
Husain Sagar and the Mir Alam, both large lakes retained by great
dams. Secunderabad, the British military cantonment, is situated 51⁄2
m. N. of the residency; it includes Bolaram, the former headquarters
of the Hyderabad contingent.
HYDER ALI, or Haidar ’Ali (c. 1722-1782), Indian ruler and
commander. This Mahommedan soldier-adventurer, who, followed by
his son Tippoo, became the most formidable Asiatic rival the British
ever encountered in India, was the great-grandson of a fakir or
wandering ascetic of Islam, who had found his way from the Punjab
to Gulburga in the Deccan, and the second son of a naik or chief
constable at Budikota, near Kolar in Mysore. He was born in 1722, or
according to other authorities 1717. An elder brother, who like himself
was early turned out into the world to seek his own fortune, rose to
command a brigade in the Mysore army, while Hyder, who never
learned to read or write, passed the first years of his life aimlessly in
sport and sensuality, sometimes, however, acting as the agent of his
brother, and meanwhile acquiring a useful familiarity with the tactics
of the French when at the height of their reputation under Dupleix.
He is said to have induced his brother to employ a Parsee to purchase
artillery and small arms from the Bombay government, and to enrol
some thirty sailors of different European nations as gunners, and is
thus credited with having been “the first Indian who formed a corps
of sepoys armed with firelocks and bayonets, and who had a train of
artillery served by Europeans.” At the siege of Devanhalli (1749)
Hyder’s services attracted the attention of Nanjiraj, the minister of
the raja of Mysore, and he at once received an independent
command; within the next twelve years his energy and ability had
made him completely master of minister and raja alike, and in
everything but in name he was ruler of the kingdom. In 1763 the
conquest of Kanara gave him possession of the treasures of Bednor,
which he resolved to make the most splendid capital in India, under
his own name, thenceforth changed from Hyder Naik into Hyder Ali
Khan Bahadur; and in 1765 he retrieved previous defeat at the hands
of the Mahrattas by the destruction of the Nairs or military caste of
the Malabar coast, and the conquest of Calicut. Hyder Ali now began
to occupy the serious attention of the Madras government, which in
1766 entered into an agreement with the nizam to furnish him with
troops to be used against the common foe. But hardly had this
alliance been formed when a secret arrangement was come to
between the two Indian powers, the result of which was that Colonel
Smith’s small force was met with a united army of 80,000 men and
100 guns. British dash and sepoy fidelity, however, prevailed, first in
the battle of Chengam (September 3rd, 1767), and again still more
remarkably in that of Tiruvannamalai (Trinomalai). On the loss of his
recently made fleet and forts on the western coast, Hyder Ali now
offered overtures for peace; on the rejection of these, bringing all his
resources and strategy into play, he forced Colonel Smith to raise the
siege of Bangalore, and brought his army within 5 m. of Madras. The
result was the treaty of April 1769, providing for the mutual
restitution of all conquests, and for mutual aid and alliance in
defensive war; it was followed by a commercial treaty in 1770 with
the authorities of Bombay. Under these arrangements Hyder Ali,
when defeated by the Mahrattas in 1772, claimed British assistance,
but in vain; this breach of faith stung him to fury, and thenceforward
he and his son did not cease to thirst for vengeance. His time came
when in 1778 the British, on the declaration of war with France,
resolved to drive the French out of India. The capture of Mahé on the
coast of Malabar in 1779, followed by the annexation of lands
belonging to a dependent of his own, gave him the needed pretext.
Again master of all that the Mahrattas had taken from him, and with
empire extended to the Kistna, he descended through the passes of
the Ghats amid burning villages, reaching Conjeeveram, only 45 m.
from Madras, unopposed. Not till the smoke was seen from St
Thomas’s Mount, where Sir Hector Munro commanded some 5200
troops, was any movement made; then, however, the British general
sought to effect a junction with a smaller body under Colonel Baillie
recalled from Guntur. The incapacity of these officers,
notwithstanding the splendid courage of their men, resulted in the
total destruction of Baillie’s force of 2800 (September the 10th,
1780). Warren Hastings sent from Bengal Sir Eyre Coote, who,
though repulsed at Chidambaram, defeated Hyder thrice successively
in the battles of Porto Novo, Pollilur and Sholingarh, while Tippoo was
forced to raise the siege of Wandiwash, and Vellore was provisioned.
On the arrival of Lord Macartney as governor of Madras, the British
fleet captured Negapatam, and forced Hyder Ali to confess that he
could never ruin a power which had command of the sea. He had
sent his son Tippoo to the west coast, to seek the assistance of the
French fleet, when his death took place suddenly at Chittur in
December 1782.
See L. B. Bowring, Haidar Ali and Tipu Sultan, “Rulers of India”
series (1893). For the personal character and administration of Hyder
Ali see the History of Hyder Naik, written by Mir Hussein Ali Khan
Kirmani (translated from the Persian by Colonel Miles, and published
by the Oriental Translation Fund), and the curious work written by M.
Le Maître de La Tour, commandant of his artillery (Histoire d’Hayder-
Ali Khan, Paris, 1783). For the whole life and times see Wilks,
Historical Sketches of the South of India (1810-1817); Aitchison’s
Treaties, vol. v. (2nd ed., 1876); and Pearson, Memoirs of Schwartz
(1834).
HYDRA (or Sidra, Nidra, Idero, &c.; anc. Hydrea), an island of
Greece, lying about 4 m. off the S.E. coast of Argolis in the
Peloponnesus, and forming along with the neighbouring island of
Dokos (Dhoko) the Bay of Hydra. Pop. about 6200. The greatest
length from south-west to north-east is about 11 m., and the area is
about 21 sq. mi.; but it is little better than a rocky and treeless ridge
with hardly a patch or two of arable soil. Hence the epigram of
Antonios Kriezes to the queen of Greece: “The island produces prickly
pears in abundance, splendid sea captains and excellent prime
ministers.” The highest point, Mount Ere, so called (according to
Miaoules) from the Albanian word for wind, is 1958 ft. high. The next
in importance is known as the Prophet Elias, from the large convent
of that name on its summit. It was there that the patriot Theodorus
Kolokotrones was imprisoned, and a large pine tree is still called after
him. The fact that in former times the island was richly clad with
woods is indicated by the name still employed by the Turks,
Tchamliza, the place of pines; but it is only in some favoured spots
that a few trees are now to be found. Tradition also has it that it was
once a well-watered island (hence the designation Hydrea), but the
inhabitants are now wholly dependent on the rain supply, and they
have sometimes had to bring water from the mainland. This lack of
fountains is probably to be ascribed in part to the effect of
earthquakes, which are not infrequent; that of 1769 continued for six
whole days. Hydra, the chief town, is built near the middle of the
northern coast, on a very irregular site, consisting of three hills and
the intervening ravines. From the sea its white and handsome houses
present a picturesque appearance, and its streets though narrow are
clean and attractive. Besides the principal harbour, round which the
town is built, there are three other ports on the north coast—
Mandraki, Molo, Panagia, but none of them is sufficiently sheltered.
Almost all the population of the island is collected in the chief town,
which is the seat of a bishop, and has a local court, numerous
churches and a high school. Cotton and silk weaving, tanning and
shipbuilding are carried on, and there is a fairly active trade.
Hydra was of no importance in ancient times. The only fact in its
history is that the people of Hermione (a city on the neighbouring
mainland now known by the common name of Kastri) surrendered it
to Samian refugees, and that from these the people of Troezen
received it in trust. It appears to be completely ignored by the
Byzantine chroniclers. In 1580 it was chosen as a refuge by a body of
Albanians from Kokkinyas in Troezenia; and other emigrants followed
in 1590, 1628, 1635, 1640, &c. At the close of the 17th century the
Hydriotes took part in the reviving commerce of the Peloponnesus;
and in course of time they extended their range. About 1716 they
began to build sakturia (of from 10 to 15 tons burden), and to visit
the islands of the Aegean; not long after they introduced the
latinadika (40-50 tons), and sailed as far as Alexandria,
Constantinople, Trieste and Venice; and by and by they ventured to
France and even America. From the grain trade of south Russia more
especially they derived great wealth. In 1813 there were about
22,000 people in the island, and of these 10,000 were seafarers. At
the time of the outbreak of the war of Greek independence the total
population was 28,190, of whom 16,460 were natives and the rest
foreigners. One of their chief families, the Konduriotti, was worth
£2,000,000. Into the struggle the Hydriotes flung themselves with
rare enthusiasm and devotion, and the final deliverance of Greece
was mainly due to the service rendered by their fleets.
See Pouqueville, Voy. de la Grèce, vol. vi.; Antonios Miaoules,
Ὑπόμνημα περὶ τῆς νήσου Ὕδρας (Munich, 1834); Id. Συνοπτικὴ
ἱστορία τῶν ναυμαχιῶν διὰ τῶν πλοίων τῶν τρίων νήσων, Ὕδρας,
Πέτσων καὶ Ψαρῶν (Nauplia, 1833); Id. Ἱστορία τῆς νήσου Ὕδρας
(Athens, 1874); G. D. Kriezes, Ἱστρία τῆς νήσου Ὕδρας (Patras,
1860).
HYDRA (watersnake), in Greek legend, the offspring of Typhon
and Echidna, a gigantic monster with nine heads (the number is
variously given), the centre one being immortal. Its haunt was a hill
beneath a plane tree near the river Amymone, in the marshes of
Lerna by Argos. The destruction of this Lernaean hydra was one of
the twelve “labours” of Heracles, which he accomplished with the
assistance of Iolaus. Finding that as soon as one head was cut off
two grew up in its place, they burnt out the roots with firebrands, and
at last severed the immortal head from the body, and buried it under
a mighty block of rock. The arrows dipped by Heracles in the
poisonous blood or gall of the monster ever afterwards inflicted fatal
wounds. The generally accepted interpretation of the legend is that
“the hydra denotes the damp, swampy ground of Lerna with its
numerous springs (κεφαλαί, heads); its poison the miasmic vapours
rising from the stagnant water; its death at the hands of Heracles the
introduction of the culture and consequent purification of the soil”
(Preller). A euhemeristic explanation is given by Palaephatus (39). An
ancient king named Lernus occupied a small citadel named Hydra,
which was defended by 50 bowmen. Heracles besieged the citadel
and hurled firebrands at the garrison. As often as one of the
defenders fell, two others at once stepped into his place. The citadel
was finally taken with the assistance of the army of Iolaus and the
garrison slain.
See Hesiod, Theog., 313; Euripides, Hercules furens, 419;
Pausanias ii. 37; Apollodorus ii. 5, 2; Diod. Sic. iv. 11; Roscher’s
Lexikon der Mythologie. In the article Greek Art, fig. 20 represents the
slaying of the Lernaean hydra by Heracles.
HYDRA, in astronomy, a constellation of the southern hemisphere,
mentioned by Eudoxus (4th century b.c.) and Aratus (3rd century
b.c.), and catalogued by Ptolemy (27 stars), Tycho Brahe (19) and
Hevelius (31). Interesting objects are: the nebula H. IV. 27 Hydrae, a
planetary nebula, gaseous and whose light is about equal to an 8th
magnitude star; ε Hydrae, a beautiful triple star, composed of two
yellow stars of the 4th and 6th magnitudes, and a blue star of the 7th
magnitude; R. Hydrae, a long period (425 days) variable, the range in
Welcome to our website – the perfect destination for book lovers and
knowledge seekers. We believe that every book holds a new world,
offering opportunities for learning, discovery, and personal growth.
That’s why we are dedicated to bringing you a diverse collection of
books, ranging from classic literature and specialized publications to
self-development guides and children's books.
More than just a book-buying platform, we strive to be a bridge
connecting you with timeless cultural and intellectual values. With an
elegant, user-friendly interface and a smart search system, you can
quickly find the books that best suit your interests. Additionally,
our special promotions and home delivery services help you save time
and fully enjoy the joy of reading.
Join us on a journey of knowledge exploration, passion nurturing, and
personal growth every day!
ebookbell.com

More Related Content

PPTX
D1 Clinical Process 2223 (1).pptx
PDF
Clinical Effectiveness In Primary Care 1st Edition Mark R Baker
PPT
Building a consensus for the electronic health record
PPT
Building a consensus for the electronic health record
PPT
Building a consensus for the electronic health record
PPT
Building a consensus for the electronic health record
PPTX
Electronic Health Record Tesc 2008 Egenton
PPTX
Commissioning Care Pathways for Chronic Diseases
D1 Clinical Process 2223 (1).pptx
Clinical Effectiveness In Primary Care 1st Edition Mark R Baker
Building a consensus for the electronic health record
Building a consensus for the electronic health record
Building a consensus for the electronic health record
Building a consensus for the electronic health record
Electronic Health Record Tesc 2008 Egenton
Commissioning Care Pathways for Chronic Diseases

Similar to Developing A Unified Patientrecord A Practical Guide Thompson (20)

PDF
s12911-022-01756-2.pdf
PDF
Zondag 19 feb, John Sharp
PPTX
V.5 Nursing as a Science, Documenting and Reporting.pptx
PPT
Web 2.0 and PMRs
PPT
Delivering Quality Through eHealth and Information Technology
PPTX
Electronic Medical Records FINAL EMRs.pptx
PPTX
CIS Project
PDF
The Informed Practice Nurse Second Edition Marilyn Edwards
PDF
Working with patients online: tips for the real world
PPT
Why Healthcare Culture Must Change
PPTX
Patient record system
PPTX
Evaluation of a CIS
PPTX
Meaningful use for NYU champions
PPT
Getting a GRIP October 2007
PPTX
Impact of nursing leadership in unified approach patient care.pptx
PDF
Home health care & long-term conditions: How to succeed with personal health ...
DOCX
assessmentskillstoclarifyandidentifytheperson’shealth.docx
PDF
Visualising Health Care Practice Improvement Innovation From Within Rick Iedema
PPTX
Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk
PPTX
Clinical information system
s12911-022-01756-2.pdf
Zondag 19 feb, John Sharp
V.5 Nursing as a Science, Documenting and Reporting.pptx
Web 2.0 and PMRs
Delivering Quality Through eHealth and Information Technology
Electronic Medical Records FINAL EMRs.pptx
CIS Project
The Informed Practice Nurse Second Edition Marilyn Edwards
Working with patients online: tips for the real world
Why Healthcare Culture Must Change
Patient record system
Evaluation of a CIS
Meaningful use for NYU champions
Getting a GRIP October 2007
Impact of nursing leadership in unified approach patient care.pptx
Home health care & long-term conditions: How to succeed with personal health ...
assessmentskillstoclarifyandidentifytheperson’shealth.docx
Visualising Health Care Practice Improvement Innovation From Within Rick Iedema
Maximizing Electronic Health Record Use in Physician Practices to Minimize Risk
Clinical information system
Ad

Recently uploaded (20)

PDF
Chinmaya Tiranga quiz Grand Finale.pdf
PDF
Paper A Mock Exam 9_ Attempt review.pdf.
PPTX
Computer Architecture Input Output Memory.pptx
PDF
FOISHS ANNUAL IMPLEMENTATION PLAN 2025.pdf
PDF
advance database management system book.pdf
PPTX
Onco Emergencies - Spinal cord compression Superior vena cava syndrome Febr...
PDF
Practical Manual AGRO-233 Principles and Practices of Natural Farming
DOC
Soft-furnishing-By-Architect-A.F.M.Mohiuddin-Akhand.doc
PPTX
Chinmaya Tiranga Azadi Quiz (Class 7-8 )
PPTX
202450812 BayCHI UCSC-SV 20250812 v17.pptx
PDF
Vision Prelims GS PYQ Analysis 2011-2022 www.upscpdf.com.pdf
PDF
LDMMIA Reiki Yoga Finals Review Spring Summer
PPTX
B.Sc. DS Unit 2 Software Engineering.pptx
PDF
ChatGPT for Dummies - Pam Baker Ccesa007.pdf
PDF
Complications of Minimal Access-Surgery.pdf
PDF
My India Quiz Book_20210205121199924.pdf
PDF
MBA _Common_ 2nd year Syllabus _2021-22_.pdf
PDF
AI-driven educational solutions for real-life interventions in the Philippine...
PDF
1.3 FINAL REVISED K-10 PE and Health CG 2023 Grades 4-10 (1).pdf
PDF
BP 704 T. NOVEL DRUG DELIVERY SYSTEMS (UNIT 2).pdf
Chinmaya Tiranga quiz Grand Finale.pdf
Paper A Mock Exam 9_ Attempt review.pdf.
Computer Architecture Input Output Memory.pptx
FOISHS ANNUAL IMPLEMENTATION PLAN 2025.pdf
advance database management system book.pdf
Onco Emergencies - Spinal cord compression Superior vena cava syndrome Febr...
Practical Manual AGRO-233 Principles and Practices of Natural Farming
Soft-furnishing-By-Architect-A.F.M.Mohiuddin-Akhand.doc
Chinmaya Tiranga Azadi Quiz (Class 7-8 )
202450812 BayCHI UCSC-SV 20250812 v17.pptx
Vision Prelims GS PYQ Analysis 2011-2022 www.upscpdf.com.pdf
LDMMIA Reiki Yoga Finals Review Spring Summer
B.Sc. DS Unit 2 Software Engineering.pptx
ChatGPT for Dummies - Pam Baker Ccesa007.pdf
Complications of Minimal Access-Surgery.pdf
My India Quiz Book_20210205121199924.pdf
MBA _Common_ 2nd year Syllabus _2021-22_.pdf
AI-driven educational solutions for real-life interventions in the Philippine...
1.3 FINAL REVISED K-10 PE and Health CG 2023 Grades 4-10 (1).pdf
BP 704 T. NOVEL DRUG DELIVERY SYSTEMS (UNIT 2).pdf
Ad

Developing A Unified Patientrecord A Practical Guide Thompson

  • 1. Developing A Unified Patientrecord A Practical Guide Thompson download https://ebookbell.com/product/developing-a-unified-patientrecord- a-practical-guide-thompson-10503072 Explore and download more ebooks at ebookbell.com
  • 2. Here are some recommended products that we believe you will be interested in. You can click the link to download. Evolutionary Case Formulation Developing A Unified Language For The Practice Of Psychotherapy https://ebookbell.com/product/evolutionary-case-formulation- developing-a-unified-language-for-the-practice-of- psychotherapy-61176536 Beyond Bios Developing With The Unified Extensible Firmware Interface Third Edition 3rd Ed Vincent Zimmer Michael Rothman Suresh Marisetty https://ebookbell.com/product/beyond-bios-developing-with-the-unified- extensible-firmware-interface-third-edition-3rd-ed-vincent-zimmer- michael-rothman-suresh-marisetty-51027326 Beyond Bios Developing With The Unified Extensible Firmware Interface 3rd Edition Vincent Zimmer https://ebookbell.com/product/beyond-bios-developing-with-the-unified- extensible-firmware-interface-3rd-edition-vincent-zimmer-10562264 Developing A Path To Data Dominance Strategies For Digital Datacentric Enterprises Arthur Langer https://ebookbell.com/product/developing-a-path-to-data-dominance- strategies-for-digital-datacentric-enterprises-arthur-langer-49602038
  • 3. Developing A Sport Psychology Consultancy Practice A Toolkit For Students And Trainees 1st Edition Vaithehy Shanmuganathanfelton https://ebookbell.com/product/developing-a-sport-psychology- consultancy-practice-a-toolkit-for-students-and-trainees-1st-edition- vaithehy-shanmuganathanfelton-50287076 Developing A Winning Grant Proposal Donald C Orlich Nancy R Shrope https://ebookbell.com/product/developing-a-winning-grant-proposal- donald-c-orlich-nancy-r-shrope-51241714 Developing A Transformation Agenda For Zimbabwe 1st Edition Shari Eppel Brian Raftopoulos https://ebookbell.com/product/developing-a-transformation-agenda-for- zimbabwe-1st-edition-shari-eppel-brian-raftopoulos-51254348 Developing A Sustainable Economy In Cameroon 1st Edition Ajab Amin https://ebookbell.com/product/developing-a-sustainable-economy-in- cameroon-1st-edition-ajab-amin-51255184 Developing A Robust And Responsive Esociety Janice Burn Sue Stoney https://ebookbell.com/product/developing-a-robust-and-responsive- esociety-janice-burn-sue-stoney-51335498
  • 6. Developing a Unified Patient Record A practical guide Deb Thompson EN, RGN, Dip HE Senior Nurse for Tissue Viability and Practice Development Weston Area Health NHS Trust, Somerset and Kim Wright RGN, BSc (Hons) Nursing Studies, MSc Health Informatics Nursing and Midwifery Informatician North Bristol NHS Trust Foreword by Yvonne Baker and Tricia Woodhead Boca Raton London New York CRC Press is an imprint of the Taylor & Francis Group, an informa business
  • 7. First published 2003 by Radcliffe Publishing Published 2018 by CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2003 Deb Thompson and Kim Wright CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works ISBN-13: 978-1-85775-939-6 (pbk) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional's own judgement, their knowledge of the patient's medical history, relevant manufacturer's instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies' and device or material manufacturers' printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming, and recording, or in any information storage or retrieval system, without written permission from the publishers. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library. Typeset by Acom Bookwork, Salisbury, Wiltshire
  • 8. Contents Foreword vi Preface viii About the authors ix About this book x Acknowledgements xi 1 Introduction 1 History and context 1 Integrated care pathways (ICPs) 3 The elements of a traditional paper record 4 2 What is a unified patient record? 11 Definition of a unified patient record 12 Multidisciplinary collaboration 12 Elements of the unified patient record 13 Benefits of a unified patient record 30 Finally... 32 3 The use of evidence-based practice within a unified patient record 33 Evidence-based practice 33 Care guides 35 Finally... 38 4 The link between record keeping and an EPR 41 Clinical language issues 42 Structure of clinical information needed for EPR 44
  • 9. iv • Contents Converting a paper framework into EPR via procurement specification 45 Decision support/evidence into practice 47 Finally... 47 5 Uses of the information within a patient record 49 Clinical governance 52 An example of improved information practice 53 Answering complaints 54 Using UPR information to improve referrals 56 Finally... 56 6 Managing change 59 Characteristics of change 59 Culture change within the clinical professions 61 The context of change 63 Strategies to support change 67 Raising awareness 67 Process mapping 68 Sustaining change 68 National initiatives to promote change 69 Coping with restraints 69 Recommendations 70 Finally... 72 7 Frequently asked questions 75 8 Toolkit for the development of a unified patient record 79 How to start the process of change 79 How to establish a baseline 80 How to develop a framework for collecting information 80 How to use existing integrated care pathways 81 How to develop evidence-based care guides 81 How to make arrangements to use the Gloucester Patient Profile 82 How to do a pilot, and learn from it 82 How to prepare for rollout 85 Things to expect during the project 93 How to maintain the momentum of the project 94 How to provide ongoing training 95 Finally... 95 9 Example of a unified patient record 97 Gloucester Patient Profile 98
  • 10. Contents • v Weston Area Health Trust patient record 102 Care guides 112 Unified specialist assessments andrecords 120 Glossary of terms 131 Further reading 135 Index 137
  • 11. Foreword High quality, shared record keeping is recognised as being fundamentally important to good patient care. There is plenty of evidence about how vital it is, for example in Learning from Bristol1 and An Organisation with a Memory,2 as well as it being a consistent theme in Information for 3 and all the subsequent strategy documents around health informatics. It is one of the ways we get over the need for professional specialisation whilst taking account of the patient's needs in a holistic manner. It is very easy to assume that these improvements can only take place when technology is available to support it, but Deb and Kim prove that it is not so much the availability of electronic systems that is key to progress, but cultural change, especially in relation to clinical informatics practice. Quite simply, before technology can help us we need to know what we want to achieve from it. It was this belief that led Weston Area Health NHS Trust and Avon IM&T Consortium to support the New Patient Record project. This book offers an excellent practical approach to addressing the changes needed in clinical record keeping to support improved patient care, clinical governance, better management information and the move towards electronic patient records (EPRs). It brings together a strong clinical focus with the informatics principles needed to support a successful move to modem record keeping. Using simple tools, Deb and Kim have led the development of a clinical information culture at Weston. These sorts of improvement could be achieved elsewhere as long as there is the will and drive to change. It is important never to underestimate the challenges of implementing change. This is especially so in clinical practice. Clinical practice is forever changing and healthcare professionals rely on traditional methods of recording patient details to provide consistency. This consistent approach
  • 12. Foreword • vii provides an anchor in a challenging world. To change such a fundamental task as record keeping without diminishing patient care takes time, reassurance, education and support. Making sense of change is a key component to successful implementation. Ways of helping staff to make sense of change are fundamental tools of a successful change agent. Deb and Kim provide details of a toolbox and route map to others wishing to take the same progressive step. This approach is already starting to be adopted locally in other organ­ isations as part of the implementation of electronic records. It has also served as a beacon to other staff groups needing to change their record keeping in preparation for the EPR. From an informatics perspective, we see this work as a vital part of the implementation of electronic records and, ultimately, integrated care records as outlined in Delivering 21st Century IT Support for the NHSf We both hope that other communities will be enthused by the practicality and patient focus of what Deb and Kim have done in their hospitals, and feel inspired to do the same. Yvonne Baker Tricia Woodhead Divisional Head, Project Management Director of Medicine Avon IM&T Consortium Weston Area Health NHS Trust January 2003 References 1 Department of Health (2002) Learning from Bristol. The Department of Health response to the report of the public inquiry into children's heart surgery at the Bristol Royal Infirmary 1984^-1995. HMSO, London. 2 Department of Health (2002) An Organisation with a Memory. Report of an expert group on learningfrom adverse events in the NHS. HMSO, London. 3 Bums F (1998) Information for Health. An information strategy for the modern NHS, 1998-2005. Department of Health Publications, Wetherby. 4 NHS Executive (2002) Delivering 21st Century IT Supportfor the NHS. HMSO, London.
  • 13. Preface Kim and I first worked together on a surgical ward in the early 90s and shared common interests in standard setting, documentation and improving patient care. In 1998, Kim led the development of integrated care pathways at Weston. As a junior sister, I first became involved in trustwide record-keeping issues when she became a member of the Stroke Pathway Group. It was through the work of this group that we both developed an insight into the need for a modem framework for collecting clinical information to prepare for electronic patient records. This inspired the idea for developing a new multidisciplinary system for record keeping, which was facilitated by Kim, and run on the ward that I managed. I continue to lead clinical record-keeping developments at Weston, whilst Kim has been involved in culture change issues within the Avon IM&T Consortium. The mix of nursing experience and clinical informatics expertise has enabled us to be at the cutting edge of the information agenda in clinical practice. We wrote this book to help others understand the importance of unified record keeping as an integral part of patient care, and the advantages of designing records in such a way that aggregated clinical information can be easily extracted. Please read and enjoy. Deb Thompson Kim Wright January 2003
  • 14. About the authors Deb Thompson e n , r g n , Dip h e is Senior Nurse for Tissue Viability and Practice Development at Weston Area Health NHS Trust in Somerset. She has worked as a nurse within the NHS for 23 years. Kim Wright RGN, BSc (Hons) Nursing Studies, MSc Health Informatics is 3 Nursing and Midwifery Informatician at North Bristol NHS Trust. She worked as a ward nurse for 15 years, before spending the last seven years in the NHS in clinical audit, clinical governance and health informatics.
  • 15. About this book This practical guide is intended for use by all clinicians and those who deal with clinical information. The book's aims are as follows. • To put into context the need for a change in the way clinical profes­ sionals collect, record, store and use clinical information about patients in acute settings, such as hospitals, with particular reference to the principles within Information for Health, the current NHS information strategy. • To show how clinical governance, including risk management and evidence-based practice, can be more easily addressed by modernising clinical information practice. • To help those involved in electronic patient record (EPR) procurement to develop a framework for recording care and treatment, which is suitable for transposing to EPR systems. • To give practical examples of the design and implementation of a unified multidisciplinary patient record. • To demonstrate how a clinical record can be streamlined to enable management information to be extracted as a by-product of informa­ tion recorded at the point of care, as part of the care process.
  • 16. Acknowledgements We would like to acknowledge the following organisations and people. The staff and patients of Weston Area Health NHS Trust, Somerset, for their tolerance and participation in the ongoing evolution of record­ keeping practice. Particular thanks go to the staff of Bimbeck Ward and the documentation link nurses. The clinical governance department at Gloucester Royal Infirmary, namely Graham Hodgson and Cheryl Haswell, for allowing us to use and build upon the Gloucester Patient Profile. Our families, for putting up with our utter distraction from normal life during the writing of this book.
  • 18. Introduction History and context This chapter summarises the evolution of clinical records over the last century, up to the present day, and introduces the concept of change required to modernise record keeping in preparation for an electronic solution. The written healthcare record has a long history, stemming from the days of Florence Nightingale, and the efforts of doctors to transfer thinking to paper.1 The creation of the Lloyd-George folder in the 1920s, still in use by GPs, was the start of the recording of medical information. The use of case notes in hospitals started as an aide-memoire for doctors, but has become increasingly complex, multi-dimensional and tied up in bureaucracy. Within nursing, research shows a tension between the profession­ alism of using a model of care such as Roper2 to express nurs­ ing work, and the reality of workplace record keeping on the wards.3 Things have changed since nursing models were introduced, managers now use documentation as a quality assurance mechanism, and all profes­ sions are judged by the quality of care. Standards of care are central to the NHS modernisation agenda.4 The Audit Commission5 showed that 25% of clinical time is spent on record keeping, most of which is repetitive. The pressure to document properly to defend against litigation means that records have become little more than an elaborate accounting mechanism.3 Nurses in particular 1
  • 19. 2 • Developing a unified patient record are being forced to give more attention to record keeping than to nursing care. Information for Health,6 the government's strategy to introduce informa­ tion and information technology (IT) to the NHS, places importance on the need for accurate, concise, person-based information in the context of the electronic patient record (EPR). The NHS Plan and Building the Informa­ tion Core merge to give more concrete guidance about how to achieve it. For example: 'information systems will need to support health care professionals in addressing the requirements of the earlier modernisation agenda by effective clinical audit information as a by-product of patient care.' NHS Executive4'7 During the mid 1990s, the Audit Commission looked into the status of hospital and community patient records and drew conclusions about the information within them, the way they were structured, used and stored, and the future.5,8 One of the main conclusions of the hospital study was that: 'before technology can be used effectively, hospitals need to improve their manual systems.' Setting the Records Straight (p57)8 In order for the impact of the impending EPR to be less disruptive, the change in recording to achieve this needs to happen on paper first. We believe that the structure and content of a unified paper record is linked strongly to the successful implementation and use of an EPR. Assessment is the key to care.9 The nature of record keeping for each profession is that of individual assessment and free text recording of treat­ ment and care. Unfortunately, each profession undertakes separate assess­ ments, which can be tediously repetitive for the patient/carers. Within comprehensive, unified and timely assessment, routine and repetitive care can be recorded quickly and easily, with attention paid to what is special about the patient, known as 'documentation by exception'. Integrated care pathways (ICPs) are also central to the modernisation agenda and Information for Health - they allow systematic audit, documentation by exception and standardisation of information. In addition, the pathway development process allows all disciplines involved with the patient, from receptionist to clinical coder and clinical professional, to examine processes of care together with the patient at the centre.
  • 20. Introduction • 3 In recent years we have recognised that documentation carries a large amount of risk, because of the following. • Communication between professions is fragmented due to the major differences between the documentation they use. This is compounded by the fact that notes are kept in several different places. • Nursing care plans are notoriously hard to decipher and because they are time-consuming to complete, the information within them is often of poor quality. Specialist staff often have to duplicate information in two or three different sets of notes to ensure adequate communication. • In order to follow through an episode of care, for example to answer a complaint, it is necessary to leaf through several different sections of the notes to gain information from the same time period. • The medical record itself usually includes pages of paper on which is written one sentence, or a page for a risk assessment where the assess­ ment is carried out once during an admission. • Along with spare sheets filed unnecessarily and an abundance of single fluid charts, the bulk of the notes is increased, contributing to storage and handling problems. In the late 1990s, the promise of a technological solution to the problems caused by the complexity and inconvenience of paper records was on the horizon. In 1998 the NHS Information Policy Unit (NHSIPU) stated that: 'training, cultural changes and improved ways of working are active compon­ ents in an information-enabled NHS.' Working Together with Health Information10 Clinical practice at the time was focused on ways of working that did not match the working practices needed to make full use of an EPR. Integrated care pathways The National Pathways Association11 describe an integrated care pathway (ICP) as a tool that: 'determines locally agreed, multidisciplinary practice based on guidelines and evidence where available, for a specific patient/client group. It forms all or part of the clinical record, documents the care given and facilitates the evaluation of outcomes for continuous monitoring.' Developing Care Pathways11
  • 21. Other documents randomly have different content
  • 22. pattern. Darwin already had pointed to the act of fertilization as the determining point, and it is in this direction that the theory of hybridism has made the greatest advance. The starting-point of the modern views comes from the experiments and conclusions on plant hybrids made by Gregor Mendel and published in 1865. It is uncertain if Darwin had paid attention to this work; Romanes, writing in the 9th edition of this Encyclopaedia, cited it without comment. First H. de Vries, then W. Bateson and a series of observers returned to the work of Mendel (see Mendelism), and made it the foundation of much experimental work and still more theory. It is still too soon to decide if the confident predictions of the Mendelians are justified, but it seems clear that a combination of Mendel’s numerical results with Weismann’s (see Heredity) conception of the particulate character of the germ-plasm, or hereditary material, is at the root of the phenomena of hybridism, and that Darwin was justified in supposing it to lie outside the sphere of natural selection and to be a fundamental fact of living matter. Authorities.—Apellö, “Über einige Resultate der Kreuzbefruchtung bei Knochenfischen,” Bergens mus. aarbog (1894); Bateson, “Hybridization and Cross-breeding,” Journal of the Royal Horticultural Society (1900); J. L. Bonhote, “Hybrid Ducks,” Proc. Zool. Soc. of London (1905), p. 147; Boveri, article “Befruchtung,” in Ergebnisse der Anatomie und Entwickelungsgeschichte von Merkel und Bonnet, i. 385-485; Cornevin et Lesbre, “Étude sur un hybride issu d’une mule féconde et d’un cheval,” Rev. Sci. li. 144; Charles Darwin, Origin of Species (1859), The Effects of Cross and Self-Fertilization in the Vegetable Kingdom (1878); Delage, La Structure du protoplasma et les théories sur l’hérédité (1895, with a literature); de Vries, “The Law of Disjunction of Hybrids,” Comptes rendus (1900), p. 845; Elliot,
  • 23. Hybridism; Escherick, “Die biologische Bedeutung der Genitalabhänge der Insecten,” Verh. z. B. Wien, xlii. 225; Ewart, The Penycuik Experiments (1899); Focke, Die Pflanzen-Mischlinge (1881); Foster- Melliar, The Book of the Rose (1894); C. F. Gaertner, various papers in Flora, 1828, 1831, 1832, 1833, 1836, 1847, on “Bastard-Pflanzen”; Gebhardt, “Über die Bastardirung von Rana esculenta mit R. arvalis,” Inaug. Dissert. (Breslau, 1894); G. Mendel, “Versuche über Pflanzen- Hybriden,” Verh. Natur. Vereins in Brünn (1865), pp. 1-52; Morgan, “Experimental Studies,” Anat. Anz. (1893), p. 141; id. p. 803; G. J. Romanes, “Physiological Selection,” Jour. Linn. Soc. xix. 337; H. Scherren, “Notes on Hybrid Bears,” Proc. Zool. Soc. of London (1907), p. 431; Saunders, Proc. Roy. Soc. (1897), lxii. 11; Standfuss, “Études de zoologie expérimentale,” Arch. Sci. Nat. vi. 495; Suchetet, “Les Oiseaux hybrides rencontrés à l’état sauvage,” Mém. Soc. Zool. v. 253-525, and vi. 26-45; Vernon, “The Relation between the Hybrid and Parent Forms of Echinoid Larvae,” Proc. Roy. Soc. lxv. 350; Wallace, Darwinism (1889); Weismann, The Germ-Plasm (1893). (P. C. M) HYDANTOIN (glycolyl urea), C3H4N2O2 or the ureïde of glycollic acid, may be obtained by heating allantoin or alloxan with hydriodic acid, or by heating bromacetyl urea with alcoholic ammonia. It crystallizes in needles, melting at 216° C. When hydrolysed with baryta water yields hydantoic (glycoluric)acid, H2N·CO·NH·CH2·CO2H, which is readily soluble in hot
  • 24. water, and on heating with hydriodic acid decomposes into ammonia, carbon dioxide and glycocoll, CH2·NH2·CO2·H. Many substituted hydantoins are known; the α-alkyl hydantoins are formed on fusion of aldehyde- or ketone-cyanhydrins with urea, the β-alkyl hydantoins from the fusion of mono-alkyl glycocolls with urea, and the γ-alkyl hydantoins from the action of alkalis and alkyl iodides on the α- compounds. γ-Methyl hydantoin has been obtained as a splitting product of caffeine (E. Fischer, Ann., 1882, 215, p. 253). HYDE, the name of an English family distinguished in the 17th century. Robert Hyde of Norbury, Cheshire, had several sons, of whom the third was Lawrence Hyde of Gussage St Michael, Dorsetshire. Lawrence’s son Henry was father of Edward Hyde, earl of Clarendon (q.v.), whose second son by his second wife was Lawrence, earl of Rochester (q.v.); another son was Sir Lawrence Hyde, attorney-general to Anne of Denmark, James I.’s consort; and a third son was Sir Nicholas Hyde (d. 1631), chief-justice of England. Sir Nicholas entered parliament in 1601 and soon became prominent as an opponent of the court, though he does not appear to have distinguished himself in the law. Before long, however, he deserted the popular party, and in 1626 he was employed by the duke of Buckingham in his defence to impeachment by the Commons; and in the following year he was appointed chief-justice of the king’s bench, in which office it fell to him to give judgment in the celebrated case of Sir Thomas Darnell and others who had been committed to prison on warrants signed by members of the privy council, which contained
  • 25. no statement of the nature of the charge against the prisoners. In answer to the writ of habeas corpus the attorney-general relied on the prerogative of the crown, supported by a precedent of Queen Elizabeth’s reign. Hyde, three other judges concurring, decided in favour of the crown, but without going so far as to declare the right of the crown to refuse indefinitely to show cause against the discharge of the prisoners. In 1629 Hyde was one of the judges who condemned Eliot, Holles and Valentine for conspiracy in parliament to resist the king’s orders; refusing to admit their plea that they could not be called upon to answer out of parliament for acts done in parliament. Sir Nicholas Hyde died in August 1631. Sir Lawrence Hyde, attorney-general to Anne of Denmark, had eleven sons, four of whom were men of some mark. Henry was an ardent royalist who accompanied Charles II. to the continent, and returning to England was beheaded in 1650; Alexander (1598-1667) became bishop of Salisbury in 1665; Edward (1607-1659) was a royalist divine who was nominated dean of Windsor in 1658, but died before taking up the appointment, and who was the author of many controversial works in Anglican theology; and Robert (1595-1665) became recorder of Salisbury and represented that borough in the Long Parliament, in which he professed royalist principles, voting against the attainder of Strafford. Having been imprisoned and deprived of his recordership by the parliament in 1645/6, Robert Hyde gave refuge to Charles II. on his flight from Worcester in 1651, and on the Restoration he was knighted and made a judge of the common pleas. He died in 1665. Henry Hyde (1672-1753), only son of Lawrence, earl of Rochester, became 4th earl of Clarendon and 2nd earl of Rochester, both of which titles became extinct at his death. He was in no way distinguished, but his wife Jane Hyde, countess of Clarendon and Rochester (d. 1725), was a famous beauty celebrated
  • 26. by the homage of Swift, Prior and Pope, and by the groundless scandal of Lady Mary Wortley Montagu. Two of her daughters, Jane, countess of Essex, and Catherine, duchess of Queensberry, were also famous beauties of the reign of Queen Anne. Her son, Henry Hyde (1710-1753), known as Viscount Cornbury, was a Tory and Jacobite member of parliament, and an intimate friend of Bolingbroke, who addressed to him his Letters on the Study and Use of History, and On the Spirit of Patriotism. In 1750 Lord Cornbury was created Baron Hyde of Hindon, but, as he predeceased his father, this title reverted to the latter and became extinct at his death. Lord Cornbury was celebrated as a wit and a conversationalist. By his will he bequeathed the papers of his great-grandfather, Lord Clarendon, the historian, to the Bodleian Library at Oxford. See Lord Clarendon, The Life of Edward, Earl of Clarendon (3 vols., Oxford, 1827); Edward Foss, The Judges of England (London, 1848- 1864); Anthony à Wood, Athenae oxonienses (London, 1813-1820); Samuel Pepys, Diary and Correspondence, edited by Lord Braybrooke (4 vols., London, 1854). HYDE, THOMAS (1636-1703), English Orientalist, was born at Billingsley, near Bridgnorth, in Shropshire, on the 29th of June 1636. He inherited his taste for linguistic studies, and received his first lessons in some of the Eastern tongues, from his father, who was rector of the parish. In his sixteenth year Hyde entered King’s College, Cambridge, where, under Wheelock, professor of Arabic, he
  • 27. made rapid progress in Oriental languages, so that, after only one year of residence, he was invited to London to assist Brian Walton in his edition of the Polyglott Bible. Besides correcting the Arabic, Persic and Syriac texts for that work, Hyde transcribed into Persic characters the Persian translation of the Pentateuch, which had been printed in Hebrew letters at Constantinople in 1546. To this work, which Archbishop Ussher had thought well-nigh impossible even for a native of Persia, Hyde appended the Latin version which accompanies it in the Polyglott. In 1658 he was chosen Hebrew reader at Queen’s College, Oxford, and in 1659, in consideration of his erudition in Oriental tongues, he was admitted to the degree of M.A. In the same year he was appointed under-keeper of the Bodleian Library, and in 1665 librarian-in-chief. Next year he was collated to a prebend at Salisbury, and in 1673 to the archdeaconry of Gloucester, receiving the degree of D.D. shortly afterwards. In 1691 the death of Edward Pococke opened up to Hyde the Laudian professorship of Arabic; and in 1697, on the deprivation of Roger Altham, he succeeded to the regius chair of Hebrew and a canonry of Christ Church. Under Charles II., James II. and William III. Hyde discharged the duties of Eastern interpreter to the court. Worn out by his unremitting labours, he resigned his librarianship in 1701, and died at Oxford on the 18th of February 1703. Hyde, who was one of the first to direct attention to the vast treasures of Oriental antiquity, was an excellent classical scholar, and there was hardly an Eastern tongue accessible to foreigners with which he was not familiar. He had even acquired Chinese, while his writings are the best testimony to his mastery of Turkish, Arabic, Syriac, Persian, Hebrew and Malay. In his chief work, Historia religionis veterum Persarum (1700), he made the first attempt to correct from Oriental sources the errors of the Greek and Roman historians who had described the religion of
  • 28. the ancient Persians. His other writings and translations comprise Tabulae longitudinum et latitudinum stellarum fixarum ex observatione principis Ulugh Beighi (1665), to which his notes have given additional value; Quatuor evangelia et acta apostolorum lingua Malaica, caracteribus Europaeis (1677); Epistola de mensuris et ponderibus serum sive sinensium (1688), appended to Bernard’s De mensuris et ponderibus antiquis; Abraham Peritsol itinera mundi (1691); and De ludis orientalibus libri II. (1694). With the exception of the Historia religionis, which was republished by Hunt and Costard in 1760, the writings of Hyde, including some unpublished MSS., were collected and printed by Dr Gregory Sharpe in 1767 under the title Syntagma dissertationum quas olim ... Thomas Hyde separatim edidit. There is a life of the author prefixed. Hyde also published a catalogue of the Bodleian Library in 1674. HYDE, a market town and municipal borough in the Hyde parliamentary division of Cheshire, England, 71⁄2 m. E. of Manchester, by the Great Central railway. Pop. (1901) 32,766. It lies in the densely populated district in the north-east of the county, on the river Tame, which here forms the boundary of Cheshire with Lancashire. To the east the outlying hills of the Peak district of Derbyshire rise abruptly. The town has cotton weaving factories, spinning mills, print-works, iron foundries and machine works; also manufactures of hats and margarine. There are extensive coal mines in the vicinity. Hyde is wholly of modern growth, though it contains a few ancient houses,
  • 29. such as Newton Hall, in the part of the town so called. The old family of Hyde held possession of the manor as early as the reign of John. The borough, incorporated in 1881, is under a mayor, 6 aldermen and 18 councillors. Area, 3081 acres. HYDE DE NEUVILLE, JEAN GUILLAUME, Baron (1776-1857), French politician, was born at La Charité-sur-Loire (Nièvre) on the 24th of January 1776, the son of Guillaume Hyde, who belonged to an English family which had emigrated with the Stuarts after the rebellion of 1745. He was only seventeen when he successfully defended a man denounced by Fouché before the revolutionary tribunal of Nevers. From 1793 onwards he was an active agent of the exiled princes; he took part in the Royalist rising in Berry in 1796, and after the coup d’état of the 18th Brumaire (November 9, 1799) tried to persuade Bonaparte to recall the Bourbons. An accusation of complicity in the infernal machine conspiracy of 1800-1801 was speedily retracted, but Hyde de Neuville retired to the United States, only to return after the Restoration. He was sent by Louis XVIII. to London to endeavour to persuade the British government to transfer Napoleon to a remoter and safer place of exile than the isle of Elba, but the negotiations were cut short by the emperor’s return to France in March 1815. In January 1816 de Neuville became French ambassador at Washington, where he negotiated a commercial treaty. On his return in 1821 he declined the Constantinople embassy, and in November 1822 was elected deputy for Cosne. Shortly afterwards he was appointed French ambassador at Lisbon, where his efforts to
  • 30. oust British influence culminated, in connexion with the coup d’état of Dom Miguel (April 30, 1824), in his suggestion to the Portuguese minister to invite the armed intervention of Great Britain. It was assumed that this would be refused, in view of the loudly proclaimed British principle of non-intervention, and that France would then be in a position to undertake a duty that Great Britain had declined. The scheme broke down, however, owing to the attitude of the reactionary party in the government of Paris, which disapproved of the Portuguese constitution. This destroyed his influence at Lisbon, and he returned to Paris to take his seat in the Chamber of Deputies. In spite of his pronounced Royalism, he now showed Liberal tendencies, opposed the policy of Villèle’s cabinet, and in 1828 became a member of the moderate administration of Martignac as minister of marine. In this capacity he showed active sympathy with the cause of Greek independence. During the Polignac ministry (1829-1830) he was again in opposition, being a firm upholder of the charter; but after the revolution of July 1830 he entered an all but solitary protest against the exclusion of the legitimate line of the Bourbons from the throne, and resigned his seat. He died in Paris on the 28th of May 1857. His Mémoires et souvenirs (3 vols., 1888), compiled from his notes by his nieces, the vicomtesse de Bardonnet and the baronne Laurenceau, are of great interest for the Revolution and the Restoration.
  • 31. HYDE PARK, a small township of Norfolk county, Massachusetts, U.S.A., about 8 m. S.W. of the business centre of Boston. Pop. (1890) 10,193; (1900) 13,244, of whom 3805 were foreign-born; (1910 census) 15,507. Its area is about 41⁄2 sq. m. It is traversed by the New York, New Haven & Hartford railway, which has large repair shops here, and by the Neponset river and smaller streams. The township contains the villages of Hyde Park, Readville (in which there is the famous “Weil” trotting-track), Fairmount, Hazelwood and Clarendon Hills. Until about 1856 Hyde Park was a farmstead. The value of the total factory product increased from $4,383,959 in 1900 to $6,739,307 in 1905, or 53.7%. In 1868 Hyde Park was incorporated as a township, being formed of territory taken from Dorchester, Dedham and Milton. HYDERABAD, or Haidarabad, a city and district of British India, in the Sind province of Bombay. The city stands on a hill about 3 m. from the left bank of the Indus, and had a population in 1901 of 69,378. Upon the site of the present fort is supposed to have stood the ancient town of Nerankot, which in the 8th century submitted to Mahommed bin Kasim. In 1768 the present city was founded by Ghulam Shah Kalhora; and it remained the capital of Sind until 1843, when, after the battle of Meeanee, it was surrendered to the British, and the capital transferred to Karachi. The city is built on the most northerly hills of the Ganga range, a site of great natural strength. In the fort, which covers an area of 36 acres, is the arsenal of the province, transferred thither from Karachi in 1861, and the palaces of
  • 32. the ex-mirs of Sind. An excellent water supply is derived from the Indus. In addition to manufactures of silk, gold and silver embroidery, lacquered ware and pottery, there are three factories for ginning cotton. There are three high schools, training colleges for masters and mistresses, a medical school, an agricultural school for village officials, and a technical school. The city suffered from plague in 1896-1897. The District of Hyderabad has an area of 8291 sq. m., with a population in 1901 of 989,030, showing an increase of 15% in the decade. It consists of a vast alluvial plain, on the left bank of the Indus, 216 m. long and 48 broad. Fertile along the course of the river, it degenerates towards the east into sandy wastes, sparsely populated, and defying cultivation. The monotony is relieved by the fringe of forest which marks the course of the river, and by the avenues of trees that line the irrigation channels branching eastward from this stream. The south of the district has a special feature in its large natural water-courses (called dhoras) and basin-like shallows (chhaus), which retain the rains for a long time. A limestone range called the Ganga and the pleasant frequency of garden lands break the monotonous landscape. The principal crops are millets, rice, oil- seeds, cotton and wheat, which are dependent on irrigation, mostly from government canals. There is a special manufacture at Hala of glazed pottery and striped cotton cloth. Three railways traverse the district: (1) one of the main lines of the North-Western system, following the Indus valley and crossing the river near Hyderabad; (2) a broad-gauge branch running south to Badin, which will ultimately be extended to Bombay; and (3) a metre-gauge line from Hyderabad city into Rajputana.
  • 33. HYDERABAD, Haidarabad, also known as the Nizam’s Dominions, the principal native state of India in extent, population and political importance; area, 82,698 sq. m.; pop. (1901) 11,141,142, showing a decrease of 3.4% in the decade; estimated revenue 41⁄2 crores of Hyderabad rupees (£2,500,000). The state occupies a large portion of the eastern plateau of the Deccan. It is bounded on the north and north-east by Berar, on the south and south-east by Madras, and on the west by Bombay. The country presents much variety of surface and feature; but it may be broadly divided into two tracts, distinguished from one another geologically and ethnically, which are locally known from the languages spoken as Telingana and Marathwara. In some parts it is mountainous, wooded and picturesque, in others flat and undulating. The open country includes lands of all descriptions, including many rich and fertile plains, much good land not yet brought under cultivation, and numerous tracts too sterile ever to be cultivated. In the north-west the geological formations are volcanic, consisting principally of trap, but in some parts of basalt; in the middle, southern and south-western parts the country is overlaid with gneissic formations. The territory is well watered, rivers being numerous, and tanks or artificial pieces of water abundant, especially in Telingana. The principal rivers are the Godavari, with its tributaries the Dudna, Manjira and Pranhita; the Wardha, with its tributary the Penganga; and the Kistna, with its tributary the Tungabhadra. The climate may be considered in general good; and as there are no arid bare deserts, hot winds are little felt. More than half the revenue of the state is derived from the land, and the development of the country by irrigation and railways has caused considerable expansion in this revenue, though the rate of increase in the decade 1891-1901 was retarded by a succession of unfavourable seasons. The soil is generally fertile, though in some
  • 34. parts it consists of chilka, a red and gritty mould little fitted for purposes of agriculture. The principal crops are millets of various kinds, rice, wheat, oil-seeds, cotton, tobacco, sugar-cane, and fruits and garden produce in great variety. Silk, known as tussur, the produce of a wild species of worm, is utilized on a large scale. Lac, suitable for use as a resin or dye, gums and oils are found in great quantities. Hides, raw and tanned, are articles of some importance in commerce. The principal exports are cotton, oil-seeds, country- clothes and hides; the imports are salt, grain, timber, European piece- goods and hardware. The mineral wealth of the state consists of coal, copper, iron, diamonds and gold; but the development of these resources has not hitherto been very successful. The only coal mine now worked is the large one at Singareni, with an annual out-turn of nearly half a million tons. This coal has enabled the nizam’s guaranteed state railway to be worked so cheaply that it now returns a handsome profit to the state. It also gives encouragement to much- needed schemes of railway extension, and to the erection of cotton presses and of spinning and weaving mills. The Hyderabad-Godavari railway (opened in 1901) traverses a rich cotton country, and cotton presses have been erected along the line. The currency of the state is based on the hali sikka, which contains approximately the same weight of silver as the British rupee, but its exchange value fell heavily after 1893, when free coinage ceased in the mint. In 1904, however, a new coin (the Mahbubia rupee) was minted; the supply was regulated, and the rate of exchange became about 115 = 100 British rupees. The state suffered from famine during 1900, the total number of persons in receipt of relief rising to nearly 500,000 in June of that year. The nizam met the demands for relief with great liberality.
  • 35. The nizam of Hyderabad is the principal Mahommedan ruler in India. The family was founded by Asaf Jah, a distinguished Turkoman soldier of the emperor Aurangzeb, who in 1713 was appointed subahdar of the Deccan, with the title of nizam-ul-mulk (regulator of the state), but eventually threw off the control of the Delhi court. Azaf Jah’s death in 1748 was followed by an internecine struggle for the throne among his descendants, in which the British and the French took part. At one time the French nominee, Salabat Jang, established himself with the help of Bussy. But finally, in 1761, when the British had secured their predominance throughout southern India, Nizam Ali took his place and ruled till 1803. It was he who confirmed the grant of the Northern Circars in 1766, and joined in the two wars against Tippoo Sultan in 1792 and 1799. The additions of territory which he acquired by these wars was afterwards (1800) ceded to the British, as payment for the subsidiary force which he had undertaken to maintain. By a later treaty in 1853, the districts known as Berar were “assigned” to defray the cost of the Hyderabad contingent. In 1857 when the Mutiny broke out, the attitude of Hyderabad as the premier native state and the cynosure of the Mahommedans in India became a matter of extreme importance; but Afzul-ud-Dowla, the father of the present ruler, and his famous minister, Sir Salar Jang, remained loyal to the British. An attack on the residency was repulsed, and the Hyderabad contingent displayed their loyalty in the field against the rebels. In 1902 by a treaty made by Lord Curzon, Berar was leased in perpetuity to the British government, and the Hyderabad contingent was merged in the Indian army. The nizam Mir Mahbub Ali Khan Bahadur, Asaf Jah, a direct descendant of the famous nizam-ul-mulk, was born on the 18th of August 1866. On the death of his father in 1869 he succeeded to the throne as a minor, and was invested with full powers in 1884. He is notable as the originator of the Imperial Service Troops, which now
  • 36. form the contribution of the native chiefs to the defence of India. On the occasion of the Panjdeh incident in 1885 he made an offer of money and men, and subsequently on the occasion of Queen Victoria’s Jubilee in 1887 he offered 20 lakhs (£130,000) annually for three years for the purpose of frontier defence. It was finally decided that the native chiefs should maintain small but well-equipped bodies of infantry and cavalry for imperial defence. For many years past the Hyderabad finances were in a very unhealthy condition, the expenditure consistently outran the revenue, and the nobles, who held their tenure under an obsolete feudal system, vied with each other in ostentatious extravagance. But in 1902, on the revision of the Berar agreement, the nizam received 25 lakhs (£167,000) a year for the rent of Berar, thus substituting a fixed for a fluctuating source of income, and a British financial adviser was appointed for the purpose of reorganizing the resources of the state. See S. H. Bilgrami and C. Willmott, Historical and Descriptive Sketch of the Nizam’s Dominions (Bombay, 1883-1884). HYDERABAD or Haidarabad, capital of the above state, is situated on the right bank of the river Musi, a tributary of the Kistna, with Golconda to the west, and the residency and its bazaars and the British cantonment of Secunderabad to the north-east. It is the fourth largest city in India; pop. (1901) 448,466, including suburbs and cantonment. The city itself is in shape a parallelogram, with an area of more than 2 sq. m. It was founded in 1589 by Mahommed Kuli,
  • 37. fifth of the Kutb Shahi kings, of whose period several important buildings remain as monuments. The principal of these is the Char Minar or Four Minarets (1591). The minarets rise from arches facing the cardinal points, and stand in the centre of the city, with four roads radiating from their base. The Ashur Khana (1594), a ceremonial building, the hospital, the Gosha Mahal palace and the Mecca mosque, a sombre building designed after a mosque at Mecca, surrounding a paved quadrangle 360 ft. square, were the other principal buildings of the Kutb Shahi period, though the mosque was only completed in the time of Aurangzeb. The city proper is surrounded by a stone wall with thirteen gates, completed in the time of the first nizam, who made Hyderabad his capital. The suburbs, of which the most important is Chadarghat, extend over an additional area of 9 sq. m. There are several fine palaces built by various nizams, and the British residency is an imposing building in a large park on the left bank of the Musi, N.E. of the city. The bazaars surrounding it, and under its jurisdiction, are extremely picturesque and are thronged with natives from all parts of India. Four bridges crossed the Musi, the most notable of which was the Purana Pul, of 23 arches, built in 1593. On the 27th and 28th of September 1908, however, the Musi, swollen by torrential rainfall (during which 15 in. fell in 36 hours), rose in flood to a height of 12 ft. above the bridges and swept them away. The damage done was widespread; several important buildings were involved, including the palace of Salar Jang and the Victoria zenana hospital, while the beautiful grounds of the residency were destroyed. A large and densely populated part of the city was wrecked, and thousands of lives were lost. The principal educational establishments are the Nizam college (first grade), engineering, law, medical, normal, industrial and Sanskrit schools, and a number of schools for Europeans and Eurasians. Hyderabad is an important centre of general trade, and there is a cotton mill in its
  • 38. vicinity. The city is supplied with water from two notable works, the Husain Sagar and the Mir Alam, both large lakes retained by great dams. Secunderabad, the British military cantonment, is situated 51⁄2 m. N. of the residency; it includes Bolaram, the former headquarters of the Hyderabad contingent. HYDER ALI, or Haidar ’Ali (c. 1722-1782), Indian ruler and commander. This Mahommedan soldier-adventurer, who, followed by his son Tippoo, became the most formidable Asiatic rival the British ever encountered in India, was the great-grandson of a fakir or wandering ascetic of Islam, who had found his way from the Punjab to Gulburga in the Deccan, and the second son of a naik or chief constable at Budikota, near Kolar in Mysore. He was born in 1722, or according to other authorities 1717. An elder brother, who like himself was early turned out into the world to seek his own fortune, rose to command a brigade in the Mysore army, while Hyder, who never learned to read or write, passed the first years of his life aimlessly in sport and sensuality, sometimes, however, acting as the agent of his brother, and meanwhile acquiring a useful familiarity with the tactics of the French when at the height of their reputation under Dupleix. He is said to have induced his brother to employ a Parsee to purchase artillery and small arms from the Bombay government, and to enrol some thirty sailors of different European nations as gunners, and is thus credited with having been “the first Indian who formed a corps of sepoys armed with firelocks and bayonets, and who had a train of artillery served by Europeans.” At the siege of Devanhalli (1749)
  • 39. Hyder’s services attracted the attention of Nanjiraj, the minister of the raja of Mysore, and he at once received an independent command; within the next twelve years his energy and ability had made him completely master of minister and raja alike, and in everything but in name he was ruler of the kingdom. In 1763 the conquest of Kanara gave him possession of the treasures of Bednor, which he resolved to make the most splendid capital in India, under his own name, thenceforth changed from Hyder Naik into Hyder Ali Khan Bahadur; and in 1765 he retrieved previous defeat at the hands of the Mahrattas by the destruction of the Nairs or military caste of the Malabar coast, and the conquest of Calicut. Hyder Ali now began to occupy the serious attention of the Madras government, which in 1766 entered into an agreement with the nizam to furnish him with troops to be used against the common foe. But hardly had this alliance been formed when a secret arrangement was come to between the two Indian powers, the result of which was that Colonel Smith’s small force was met with a united army of 80,000 men and 100 guns. British dash and sepoy fidelity, however, prevailed, first in the battle of Chengam (September 3rd, 1767), and again still more remarkably in that of Tiruvannamalai (Trinomalai). On the loss of his recently made fleet and forts on the western coast, Hyder Ali now offered overtures for peace; on the rejection of these, bringing all his resources and strategy into play, he forced Colonel Smith to raise the siege of Bangalore, and brought his army within 5 m. of Madras. The result was the treaty of April 1769, providing for the mutual restitution of all conquests, and for mutual aid and alliance in defensive war; it was followed by a commercial treaty in 1770 with the authorities of Bombay. Under these arrangements Hyder Ali, when defeated by the Mahrattas in 1772, claimed British assistance, but in vain; this breach of faith stung him to fury, and thenceforward he and his son did not cease to thirst for vengeance. His time came
  • 40. when in 1778 the British, on the declaration of war with France, resolved to drive the French out of India. The capture of Mahé on the coast of Malabar in 1779, followed by the annexation of lands belonging to a dependent of his own, gave him the needed pretext. Again master of all that the Mahrattas had taken from him, and with empire extended to the Kistna, he descended through the passes of the Ghats amid burning villages, reaching Conjeeveram, only 45 m. from Madras, unopposed. Not till the smoke was seen from St Thomas’s Mount, where Sir Hector Munro commanded some 5200 troops, was any movement made; then, however, the British general sought to effect a junction with a smaller body under Colonel Baillie recalled from Guntur. The incapacity of these officers, notwithstanding the splendid courage of their men, resulted in the total destruction of Baillie’s force of 2800 (September the 10th, 1780). Warren Hastings sent from Bengal Sir Eyre Coote, who, though repulsed at Chidambaram, defeated Hyder thrice successively in the battles of Porto Novo, Pollilur and Sholingarh, while Tippoo was forced to raise the siege of Wandiwash, and Vellore was provisioned. On the arrival of Lord Macartney as governor of Madras, the British fleet captured Negapatam, and forced Hyder Ali to confess that he could never ruin a power which had command of the sea. He had sent his son Tippoo to the west coast, to seek the assistance of the French fleet, when his death took place suddenly at Chittur in December 1782. See L. B. Bowring, Haidar Ali and Tipu Sultan, “Rulers of India” series (1893). For the personal character and administration of Hyder Ali see the History of Hyder Naik, written by Mir Hussein Ali Khan Kirmani (translated from the Persian by Colonel Miles, and published by the Oriental Translation Fund), and the curious work written by M. Le Maître de La Tour, commandant of his artillery (Histoire d’Hayder-
  • 41. Ali Khan, Paris, 1783). For the whole life and times see Wilks, Historical Sketches of the South of India (1810-1817); Aitchison’s Treaties, vol. v. (2nd ed., 1876); and Pearson, Memoirs of Schwartz (1834). HYDRA (or Sidra, Nidra, Idero, &c.; anc. Hydrea), an island of Greece, lying about 4 m. off the S.E. coast of Argolis in the Peloponnesus, and forming along with the neighbouring island of Dokos (Dhoko) the Bay of Hydra. Pop. about 6200. The greatest length from south-west to north-east is about 11 m., and the area is about 21 sq. mi.; but it is little better than a rocky and treeless ridge with hardly a patch or two of arable soil. Hence the epigram of Antonios Kriezes to the queen of Greece: “The island produces prickly pears in abundance, splendid sea captains and excellent prime ministers.” The highest point, Mount Ere, so called (according to Miaoules) from the Albanian word for wind, is 1958 ft. high. The next in importance is known as the Prophet Elias, from the large convent of that name on its summit. It was there that the patriot Theodorus Kolokotrones was imprisoned, and a large pine tree is still called after him. The fact that in former times the island was richly clad with woods is indicated by the name still employed by the Turks, Tchamliza, the place of pines; but it is only in some favoured spots that a few trees are now to be found. Tradition also has it that it was once a well-watered island (hence the designation Hydrea), but the inhabitants are now wholly dependent on the rain supply, and they have sometimes had to bring water from the mainland. This lack of
  • 42. fountains is probably to be ascribed in part to the effect of earthquakes, which are not infrequent; that of 1769 continued for six whole days. Hydra, the chief town, is built near the middle of the northern coast, on a very irregular site, consisting of three hills and the intervening ravines. From the sea its white and handsome houses present a picturesque appearance, and its streets though narrow are clean and attractive. Besides the principal harbour, round which the town is built, there are three other ports on the north coast— Mandraki, Molo, Panagia, but none of them is sufficiently sheltered. Almost all the population of the island is collected in the chief town, which is the seat of a bishop, and has a local court, numerous churches and a high school. Cotton and silk weaving, tanning and shipbuilding are carried on, and there is a fairly active trade. Hydra was of no importance in ancient times. The only fact in its history is that the people of Hermione (a city on the neighbouring mainland now known by the common name of Kastri) surrendered it to Samian refugees, and that from these the people of Troezen received it in trust. It appears to be completely ignored by the Byzantine chroniclers. In 1580 it was chosen as a refuge by a body of Albanians from Kokkinyas in Troezenia; and other emigrants followed in 1590, 1628, 1635, 1640, &c. At the close of the 17th century the Hydriotes took part in the reviving commerce of the Peloponnesus; and in course of time they extended their range. About 1716 they began to build sakturia (of from 10 to 15 tons burden), and to visit the islands of the Aegean; not long after they introduced the latinadika (40-50 tons), and sailed as far as Alexandria, Constantinople, Trieste and Venice; and by and by they ventured to France and even America. From the grain trade of south Russia more especially they derived great wealth. In 1813 there were about 22,000 people in the island, and of these 10,000 were seafarers. At
  • 43. the time of the outbreak of the war of Greek independence the total population was 28,190, of whom 16,460 were natives and the rest foreigners. One of their chief families, the Konduriotti, was worth £2,000,000. Into the struggle the Hydriotes flung themselves with rare enthusiasm and devotion, and the final deliverance of Greece was mainly due to the service rendered by their fleets. See Pouqueville, Voy. de la Grèce, vol. vi.; Antonios Miaoules, Ὑπόμνημα περὶ τῆς νήσου Ὕδρας (Munich, 1834); Id. Συνοπτικὴ ἱστορία τῶν ναυμαχιῶν διὰ τῶν πλοίων τῶν τρίων νήσων, Ὕδρας, Πέτσων καὶ Ψαρῶν (Nauplia, 1833); Id. Ἱστορία τῆς νήσου Ὕδρας (Athens, 1874); G. D. Kriezes, Ἱστρία τῆς νήσου Ὕδρας (Patras, 1860). HYDRA (watersnake), in Greek legend, the offspring of Typhon and Echidna, a gigantic monster with nine heads (the number is variously given), the centre one being immortal. Its haunt was a hill beneath a plane tree near the river Amymone, in the marshes of Lerna by Argos. The destruction of this Lernaean hydra was one of the twelve “labours” of Heracles, which he accomplished with the assistance of Iolaus. Finding that as soon as one head was cut off two grew up in its place, they burnt out the roots with firebrands, and at last severed the immortal head from the body, and buried it under a mighty block of rock. The arrows dipped by Heracles in the poisonous blood or gall of the monster ever afterwards inflicted fatal wounds. The generally accepted interpretation of the legend is that
  • 44. “the hydra denotes the damp, swampy ground of Lerna with its numerous springs (κεφαλαί, heads); its poison the miasmic vapours rising from the stagnant water; its death at the hands of Heracles the introduction of the culture and consequent purification of the soil” (Preller). A euhemeristic explanation is given by Palaephatus (39). An ancient king named Lernus occupied a small citadel named Hydra, which was defended by 50 bowmen. Heracles besieged the citadel and hurled firebrands at the garrison. As often as one of the defenders fell, two others at once stepped into his place. The citadel was finally taken with the assistance of the army of Iolaus and the garrison slain. See Hesiod, Theog., 313; Euripides, Hercules furens, 419; Pausanias ii. 37; Apollodorus ii. 5, 2; Diod. Sic. iv. 11; Roscher’s Lexikon der Mythologie. In the article Greek Art, fig. 20 represents the slaying of the Lernaean hydra by Heracles. HYDRA, in astronomy, a constellation of the southern hemisphere, mentioned by Eudoxus (4th century b.c.) and Aratus (3rd century b.c.), and catalogued by Ptolemy (27 stars), Tycho Brahe (19) and Hevelius (31). Interesting objects are: the nebula H. IV. 27 Hydrae, a planetary nebula, gaseous and whose light is about equal to an 8th magnitude star; ε Hydrae, a beautiful triple star, composed of two yellow stars of the 4th and 6th magnitudes, and a blue star of the 7th magnitude; R. Hydrae, a long period (425 days) variable, the range in
  • 45. Welcome to our website – the perfect destination for book lovers and knowledge seekers. We believe that every book holds a new world, offering opportunities for learning, discovery, and personal growth. That’s why we are dedicated to bringing you a diverse collection of books, ranging from classic literature and specialized publications to self-development guides and children's books. More than just a book-buying platform, we strive to be a bridge connecting you with timeless cultural and intellectual values. With an elegant, user-friendly interface and a smart search system, you can quickly find the books that best suit your interests. Additionally, our special promotions and home delivery services help you save time and fully enjoy the joy of reading. Join us on a journey of knowledge exploration, passion nurturing, and personal growth every day! ebookbell.com