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information in the pages of the professional journals, both archi tectural and medical, and will find in her book the ideas of Miss Nightingale, the authority to whose views the Government and many private individuals pay great deference. That lady has certainly a great claim to be heard, and the beautiful clearness and obvious good sense of her books make them most interesting, but you must read them with the recollection that she is a person who does not admit the possibility of her being in error. In the main her views are no doubt sound, but, on more than one point I think she, to say the least, pushes them too far. Miss Nightingale’s book is “Notes on Hospitals.” Her “Notes on Nursing,” are also valuable collateral information. There are several blue books treating on the subject directly or indi - rectly. Then we have in French, by Husson, “ Etude sur le Hopi- taux ;” and by Blondel et Ser, “ Rapport sur les Hopitaux civils de la ville de Londres.” In German we have “ Horky,” “ Studien uber Kranken Aus- talten,” and the book recently republished in English of Dr. Oppert. From these, and such books, and from a careful study of existing hospitals, you can best obtain the information now possessed by those most conversant with the subject. In doing so, you will find that in order thoroughly to master the subject which I have now superficially skimmed much knowledge of detail is necessary, for in no branch of practice is it of more importance to master every detail completely, but yet to combine the whole into a sagaciously considered comprehensive whole than when planning a hospital. Mr. Hayward said it was remarkable that hospitals had been generally built on the block system. Mr. Smith had apparently taken it for granted that that was the only proper method, but had not ex plained the reason of the adoption of that particular form. It was certain, however, that in all countries where hospitals were built doctors were agreed that the block was the proper style of hospital. Mr. Smith said that his object had been to explain modern practice, and the arrangement was almost identical in most of the best new hospitals, with only such differences as, for example, that in some instances there was one window to each bed, instead of one to every two beds as in other places. Mr. Hayward remarked that it was so far satisfactory that that point had been settled. There might be ways of arranging beds in a better manner, better if not from the doctor’s point of view, but better as regarded the comfort and cheerfulness of the patients. A great deal had been said about country sites for hospitals. The advantages of the country hospital were based chiefly on the fact that in our London hospitals the death rate was excessively high, and it was there fore maintained by some persons that the benefit to be derived by patients living in smaller buildings, and with plenty of fresh countiy air, more than counterbalanced the loss of the superior skill of the London physician. If this were true the extensive machinery of a London hospital was all a mistake. He did not say it was, but it was a question if pro fessional spirit had not carried the doctors too far in their require ments. Everybody knew that there was a limit in building large institutions beyond which it was unprofitable to go. It seemed to him that many of the plans which Mr. Smith had produced were far too elaborate to be worked with corresponding advantage. From a pecuniary point of view, therefore, it might be said that an hospital was too large for a neighbourhood for practical working. These institutions were usually founded upon a certain amount of endowment, but they had also to appeal regularly to the public for continued support. If it should be found that hospitals were too large and elaborate, and if it were found that patients were taken in more foi the consideration of the medical profession than for the Curing of their ailments, he was afraid the public would demur to support such establishments. He had lately occasion to plan a ward to be built in connection with Harrow School. It was seldom that a school required an hospital; in cases of ordinary sickness it would not be required, but only for the treatment of infectious disease. The question arose whether this sanitorium at Harrow School should be built on the plan of putting a large number together, or of having the patients in separate apartments as at Eton ; or a third plan by which some might be together and some apart. It was finally concluded that no room should be separate; that for the sake of cheerfulness, and for the advantage of company, it was desirable that all the patients should be in one apartment. The sanatorium had been erected on this principle, and he believed it had been found in practice to work exceedingly well. Mr. Blashill said the hospital was, he thought, a very particular and special form of house. A house in England was a place in which people passed the greater portion of their time. We lived and took our pleasure in doors, and if sick, in ordinary circumstances, we were treated in our own houses. But an hospital was a place where only sick people were treated. It was not so remarkable that hospitals did not exist in olden times, because it was only when the science of medicine had arrived at a certain stage that they were found neces sary. The leading idea in modern hospitals was that the utmost attention should be paid to cleanliness and ventilation. People talked about “modern notions of cleanliness cleanliness was not a modem idea but a very old one. A great part of the earlier books of the Bible was devoted to the subject, and many of the medicoval writers had thoroughly exhausted it. The moderns therefore had not dis covered any new ideas, but had only begun to apply old ones. He wished to ask Mr. Smith if he had ever remarked the effect upon patients of the large amount of window surface in hospitals. It might be well for patients not to have quite so much light, as one of the requisites of recovery was repose. He thought that in summer time especially such a large amount of light might be injurious. Mr. Ridge observed that the Lariboisiere Hospital at Paris, which had been taken as a perfect model, had been found to be by no means a model in practical working. He had read that the death rate there was quite as high as at the older mediceval hospitals. He believed that this was owing to the fact that though the building -was well supplied with windows they were never opened. The French doctors believed only in artificial ventilation ; they allowed a certain quantity of heated air of a certain temperature to be introduced into the wards in certain proportions. It was very well in theory, but practically patients did not recover under the treatment. This was a strong argument in favour of the English system of ventilation thsough open windows. He believed it was better to have a window to each bed with an equal space between the beds, rather than a window’ to every two beds and unequal spaces between the beds. Concerning the architectural treatment of hospitals it appeared to be necessary to build in separate blocks. The architect should therefore acknowledge that he was erecting so many distinct buildings, not with a view to producing the best architectural effect, but in which sick persons were to obtain the greatest amount of benefit in the shortest possible time. Mr. Matthew’s remarked that the question of ventilation was all important in connection with hospitals. In several hospitals there were comparatively few means of artificial ventilation, but one could not help being struck with the general airiness of the wards, which result was obtained by natural ventilation through the windows. King’s College Hospital was a special instance of this kind. But while natural ventilation was very good, it was obvious that for cold weather something else must be had, and they could not, therefore, reject the principle of artificial ventilation. A fire-place was of course the most obvious and necessary means of withdrawing foul air and keeping up the temperature of the wards. Fire-places in the walls were open to the objection that two or three beds were too warm, and the rest w’ere too cold. A centre fire obviated this difficulty. For cleanliness a tile or cement floor w’as, he thought, preferable to any other. It was de sirable to have a separate infection ward, especially for hospitals in provincial towns. Accident wards should be near the principle entrance of the hospital and on the ground floor. Mr. Riddett observed that centre fires in wards had the effect of making the beds in proximity to them too warm, almost as much as fires in the walls ; but that difficulty had been obviated in one instance of which he knew, by making the openings of the fire places look up or down the wards instead of facing the beds. Mr. T. R. Smith said he had avoided going much into detail, because it was apt to be tiresome to any one not previously acquainted with the subject. He had avoided the subject in its simply historical aspect, and had spoken merely of the most recent results which had been arrived at. Ventilation by windows might be used injudiciously with very disastrous results. An hospital physician lately said he would rather put a patient suffering from some complaints into the street than where there was too much draught.” Mr. Hayward had referred to the elaborateness of hospital arrangements, and had sug gested that this might be a mistake. He (Mr. Smith) thought this was very likely, but it was the temper of the present day, and to some extent it was impossible to go against the tide in which things were going. But probably simpler hospitals, especially in country districts were preferable. Upon the whole, however, for crowded cities at any rate, everything which had been done appeared to have been for the best. He believed Mr. Ridge was right in his comments upon the Lariboisiere Hospital. But in that instance artificial ventilation was the only kind used. What he contended for was a judicious use of both methods. Every hospital should have the means of introducing warm air and drawing out bad air independent of the windows, such means being used when the windows could not be safely opened. One objection to there being a window to each bed was that either the window’ must be merely a narrow slip or else that the side of the w’all must be all glass. It had to be remembered that the window must extend nearly from the floor to the ceiling. In a ward of 15 feet high the windows would be 12 feet high. It was stated that the expense of maintenance was proportionally greater in large institutions than in small ones. This w’as one of the points in whicha judicious planning