OUR NEW SKIN AND CANCER HOSPITAL. loi 



that hospital were engaged in making a report in regard to ' a village 

 of cottage hospitals,' which was printed in 187G, and is a most careful 

 and thorough study of the subject, from a scientific stand-point, and 

 is most conclusive in favor of the country plan of treating patients. 

 From this report, and also from the work on hospital construction and 

 organization issued by the Johns Hopkins Hospital, I shall draw vari- 

 ous of the facts and statements which I wish briefly to present. 



" Careful study has demonstrated beyond peradventure that the 

 nearer the condition of the patient approaches that of a member of a 

 well-ordered household, the better are the chances of recovery ; in 

 small and separate hospitals the mortality diminishes with the size of 

 the building, while in larger and more crowded hospitals the mortality 

 is found to increase proportionately, and it reaches its height in those 

 in which these conditions have existed for the longest time. 



" In the report referred to is a quotation from Sir James Y. Simp- 

 son's essay on ' Hospitalism,' giving the following figures regarding 

 mortal! t)'^ after amputations, which may be well considered in the 

 present connection : 



In large hospitals of Paris _ . . .62 per ICO die. 



In Biitish hospitals, with 300 to 600 beds, 41 " " " 



" " " " 300 " 201 " 30 " " " 



" " " " 200 " 101 " 23 " " " 



" " " " 100 " 26 " 18 " " " 



" " " " 25 beds or less, 14 " " " 



In isolated rooms in country practice . 11 " " " 



In other isolated cottage hospitals in England during the year 1869, 

 the mortality after operations was reduced to 6*7 per cent, 



" In Bellevue Hospital there Avas at one time a mortality of forty- 

 eight per cent after amputations, and at two of the public reception 

 hospitals in New York the deaths in 1870, after amputations, were re- 

 spectively sixty-five and sixty-two per cent. Other more recently 

 built and better constructed hospitals show, of course, a very much 

 smaller mortality, but the fact can not be gainsaid that large, sub- 

 stantial structures of brick and mortar, in a crowded city, do every- 

 where show a mortality much higher than that obtaining in locations 

 where pure air, quiet, and sunlight can assist in man's endeavors to 

 combat disease and injury. Spencer Wells, a prominent English sur- 

 geon, expressed the view that no surgical operation attended with risk 

 to life should ever be performed in a great general hospital in a large 

 town, except under such circumstances as would render removal to 

 the country, or to a suburban cottage hospital, more dangerous. 



"Much more could be added to show the advantages to be derived 

 from securing a country location where a certain proportion of our 

 cases could be sent, but time allows only a brief mention of important 

 points in regard to the scheme actually proposed. 



" Several locations have been under consideration for some time ; 



