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infection being carried by the wind from one block to the next. This space has been increased in some recent examples. Beyond wards there are one or two other provisions for the use of the sick, which I shall hardly do more than mention. Baths (independent of the one bath attached to each ward) ought to be provided in good central situations—for male and female patients, and of all sorts, as douche, warm, vapour, sulphur baths. Day rooms, convalescent rooms, a library, a chapel, and a covered exercising ground, or at least some of these, are parts of most complete hospitals, but their use will vary a good deal with the degree of severity of the cases usually treated. None of these things are of much service to patients who are wry ill. Wards having been considered, the next thing to provide for is administration, and this in a hospital is no trifle. I believe the personal attendants on the sick, comprising sisters, nurses, and helpers number, in a good hospital, one to every seven or eight patients, that is, one-seventh or one-eighth as many as the patients. There will also be a certain number of persons performing duties similar to those of household servants. Some engaged in the dispensary and stores, the higher nursing staff, in case any sisterhood looks after the hospital, the medi cal staff and clerks are also all to be provided for. Bed-rooms away from the wards arc required for nurses when off duty, that they may sleep undisturbed. It is not un usual to place these in an attic above the top storey of wards. For the sister, who is a superior class of person, having the responsible superintendence of one ward night and day, pro vision has already been made in assigning her a room over looking the ward. It is considered that forty sick is about the maximum number that one sister can efficiently take charge of; but to superintend so many she must have them arranged in the most accessible manner in not more than two wards. In most hospitals on the continent the nursing is superin tended and performed by those excellent women the Soeurs de Charite, and it is becoming customary in this country for sisterhoods, most of them having more or less of a religious basis, to have the care of the nursing, and most efficiently they are said to do it. In any case, in England or abroad, whore a sisterhood is engaged, a residence should be provided within the precints of the hospital, but, as far as possible, detached from all other parts of the building for the sisters, and this should be rendered cheerfid, comfortable, and commodious. Of the household work, by far the most important, is the cooking, and accordingly the kitchen should receive special attention. It must be surrounded by the necessary stores ; its neighbourhood should be accessible from without for trades men and goods to come in without approaching the ordinary entrances, but it must be as nearly central as practicable, so that the diets may be quickly carried to the lifts belonging to the various wards, and by them raised to their destination. A very liberal allowance of cooking apparatus, sculleries, store rooms, and larders are required for bread, flour, groceries, meat, fish, vegetables, in short all the endless variety of articles needed in the nourishment of the sick must be pro vided for, not forgetting a wine cellar and an icehouse. Near this department the residence and business rooms of the head or heads of the household administration, matron or steward, or both, ought to be placed. Next to food, medicine is a necessary for the sick, and an apothecary’s department, generally termed a dispensary, must also be provided in a central situation. The position of this department must be, in fact, regulated by the place of the out patients, as they have to obtain their medicines from the dispensary. Linen, bedding, bandages, all such stores require a depart ment of themselves. So does the laundry; and this ought to receive considerable care, whether a part of the hospital, or an entirely separate building, as a very large amount of work is required of it. Not to go into the details of each of these departments, I will only observe that in planning any depart ment of this sort, the most serviceable result is always obtained if the designer places his rooms so that whatever has to pass through them always travels in one direction, enters at one end, makes a tour through the department, and comes out at the other end. For instance, take a laundry. There ought to be, first, a receiving room; then beyond that the washhouse; then communicating with that the drying closet; beyond that, again, the ironing-room ; next to that a clean linen-room, with seamstress’s-room adjoining for repairs, and a giving-out win dow through which the linen goes away from the laundry department as it is wanted. There will require a controller’s or a secretary’s office, and a place for some clerks, a board room, with ante-room, and other general offices of this sort. Foi - the medical staff, sufficient preparation has to be made. Besides the rooms for the physicians and surgeons—to which I shall refer again—there are required one or more residences under the roof of the hospital for a house-surgeon, or other resident medical officer, and accommodation for a certain number of other residents who are dressers, or clinical clerks, oi' the like, is sometimes required. Easily accessible from the ward corridors, there ought to be an operating theatre; or, in large hospitals, there are sometimes two, with a northerly top-light, a private room for the surgeon, and a small ward in which one or more beds can be placed for patients who cannot at once be cairied back, after an operation, to their ward. The operating theatre must provide accommodation for those students desirous of witnessing the operations. For out-patients, the accommodation required is simple, but must be spacious. They should have an entirely separate en trance, and an attendant placed in a hall, who, from the entry on the tickets they present, or from some general notion they give him of the sort of ailment, passes them into the physi cian’s or surgeon’s waiting-rooms, in some cases again subdi vided into male and female rooms. These should he spacious and airy, as many persons are congregated in them, and some times then’ atmosphere becomes almost unbearably close. The rooms of the physician and surgeon adjoin these waiting- rooms, and patients are admitted one by one. These rooms ought to have a good north light, and to be so far contiguous that the occupant of either can consult his colleague readily. Each patient, as he has been seen, should leave the medical man’s room by a different door from that by which he entered it, and should then be able to go direct either to the hospital receiving-room, if ordered to become an in-patient, or to the surgery if any bandage or other surgical appliance is ordered; or, as is chiefly, of course, the case, to the dispensary, where the prescribed medicine will be given out. Some arrangement for receiving the patients’ prescriptions at one window, passing the patients into a waiting-room, and then issuing their medi cines to them from another window, must also be provided. These rooms must bo properly supplied with closets. The out-patients should leave the hospital by a distinct exit, and neither the entrance nor the exit should be the same as the principal public entrance. The rooms of the physician and surgeon should, of course, communicate with a corridor leading into the interim - of the hospital. A receiving-room near the public entrance, which, by-the-byc, should be unmistakeable and well marked, is re quired for accidents and persons -who come as in-patients direct; and an accident ward ought to adjoin the room. St. Thomas’s Hospital will also provide near here a casualty ward, where persons who are injured, but not very seriously, will be attended to, and where small operations may be performed, This is often part of the out-patients’ department. A medical school is usually part of the economy of each great hospital, and it requires a certain amount of provision to be made for it. The width of the wards themselves is in part dictated by the necessity for enabling a considerable assem blage of students to go round with the physician or surgeon on duty each day. The instruction thus given at the bedside is called clinical lectures ; but, in addition thereto, at each medical school, lectures on various subjects, such as anatomy, surgery, disease, and medicine are given. One or more lec turing-theatres are to be provided among the school-buildings in which these take place, with proper professors’ rooms, and room for preparations, experiments, &c., to be exhibited. Ad joining here, there ought to be a library, to contain medical works, and for students to read and write in, and amuseum for anatomical preparations and the like. One or more dissecting-rooms are also required, which should be well ventilated and lighted with a top-light; and not far from them the dead-house, to which the bodies of patients who die in the hospital are taken. Adjoining this there is usually a post-mortem room ; and it would often be a useful precaution to add an inquest-room, as coroners’ inquests are from time to time held in all our hospitals. Lastly, in connection with the schools, it is in some cases