HOSPITALS 



806 



(Hi,-. 1728). Tffe (1H52). Porter (IKM). I* 



'); and IMavilk* <! Itoux'i La Arrhirr*. la 

 BMiotMmte, et la Trftar de I'Ordre de St-Jean a Malte 



(mi). 



Hospitals are HO called from tin- iin-.lii-v.-il 



hnnfiitin, or n- properly the clans of hospitals 



established very gem-rally f" r ln( ' reception ami 

 relief of lepers, whose malady was one of the 

 scourges of Knro|<>. These leper hospitals were 

 Vy Commonly in England and in Scotland called 

 Spitals;' hence tin- frequency of such names of 

 places as Spital, SpitallicliU, \<-. The leper hos- 

 pitals and other kinds of the old hospitia dis- 

 appeareii with the improvement of society, and 

 suli-titiites for them on a broader scale began \<> l>e 

 established in the modern form of hospitals. Of 

 public establishments under this general designa- 

 tion there are now, as is commonly known, three 

 distinct classes -hospitals for the reception and 

 treatment of the sick and hurt, hospitals for the 

 hoard and education of children, and hospitals for 

 the reception and permanent board of poor old 

 persons of both sexes. As in the present work the 

 more remarkable hospitals receive some notice under 

 their respective heads, we need here only otter a 

 few general observations. 



Ho-pitals for the sick and hurt are in some 

 parts of England and Scotland termed Infirmaries. 

 Under whatever designation, institutions of this 

 kind are now established in all parts of the civilised 

 world. They are supported in most cases on a 

 principle of charity, but in some special instances 

 from the funds of the state or the civic munici- 

 palities. The primary or more important object of 

 all such institutions is to mitigate bodily suffering, 

 whether that arises from natural or accidental 

 causes, in which respect they are indispensable as 

 a refuge to all who are unable to pay for private 

 medical or surgical aid, or as a convenient means 

 of succour on emergencies to persons of every rank 

 and degree of opulence. While such is the main 

 object of these benevolent institutions, they are 

 also serviceable as schools for medicine and surgery ; 

 as such, no university, at which these and kindred 

 branches of learning are taught, can be said to be 

 complete without the adjunct of a well -organised 

 hospital, where professors can practically educate 

 their pupils by pointing out varieties of disease and 

 injuries, and exemplifying methods of treatment. 

 Hence the best specimens of hospitals are found in 

 university towns as in London, Paris, Edinburgh, 

 and some other cities famed as schools of medicine 

 and surgery. The older of the London hospitals 

 are St Thomas's (1553), St Bartholomew's (1546), 

 and Bedlam or Bethlehem ( 1547), to which may be 

 added the Westminster (1719), Guy's (1725), the 

 Lock ( 17415 K St George's ( 1733), the London ( 1740), 

 the Middlesex (1745), and University College 

 (1833). A considerable accession to the number 

 took place in the reign of George II., when society 

 became alive to the value of such institutions. It 

 was at this period that the Royal Infirmary of 

 Edinburgh was established (1730). The antiquity 

 of British hospitals sinks into insignificance in com- 

 parison with that of some institutions of this kind 

 on the Continent. The Hdtel Dieu in Paris, which 

 is alleged to be the most ancient hospital in Europe, 

 was founded in the 7th century, and, long known as 

 the Maison Dieu, received the l>enefactions of suc- 

 cessive sovereigns. 



In London, Paris, and other large seats of popula- 

 tion, l>esides the general luxspitals, there are now 

 lying-in hospitals, ophthalmic hospitals, consump- 

 tive hospitals, children's hospitals, &c. each with 

 its peculiar accommodation and staff of officials. 

 Convalescent Hospitals (q.v.) are a valuable ad- 

 junct to ordinary hospitals for the sick. In- 

 dependently of these there are hospitals for the 



treatment of mental maladies, of which Bethlehem 

 ;>nd St Luke'* in l/ondnn. and the establishment* 

 in Paris, known a* HoMpices, are example*. To 

 this chiHH of institution* In-long Lunatic Asylum* 

 (q.v. ), also asylum* for the reception and treat- 

 ment of naturally imlM-cilc children ; these lout, 

 though in ojMTation for some time in France and 

 Swit/erland, leing hut of recent establishment in 

 Great Britain. To these must IN; added the isola- 

 tion hospitals for the treatment of smallpox, 

 scarlet- fever, and other forms of infectious diseases, 

 which have lieen established in recent years by 

 every energetic sanitary authority out of the 

 rates. Be-i.l.-- these in-tii utio.M- u!ii>-i .-i-.il ad 

 ministration are those hospitals which are main 

 tained by the English, French, and other govern- 

 ments for the military and naval services. In the 

 United States, where every medical college has iu 

 own hospital, or the right to teach in the wards of 

 public institutions, there are also many hospitals 

 or asylums for inebriates (see IXKUKIATKS), for 

 opium-users, and those addicted to the use of 

 other narcotics (see also FOUNDLING HOSPITALS, 

 AMBULANCE). 



Until the middle of the 19th century the organ- 

 isation and management of hospitals and the 

 nursing of the sick in Britain and in most parts 

 of Europe were, except in some few in-t.-tn.-i-, 

 extremely defective. Public opinion was then 

 aroused on the question, and certain principles 

 were laid down on hospital construction and hos- 

 pital nursing which have l>een recognised and 

 adopted to a greater or less extent since that time. 

 These principles may be briefly summed up as 

 follows under the three heads : ( 1 ) Construction, 

 (2) Administration, (3) Nursing. 



(1) Construction. The first object is to obtain 

 pure air in and around the building. The purity 

 of air around will depend upon the site. The 

 soil should be clean and dry ; the position should 

 admit of free circulation of air untainted by sur- 

 rounding sources of impurity or damp. The num- 

 ber of sick who can be placed on a given site de- 

 pends on the form of tne buildings in which they 

 are to be placed. It is now considered that more 

 than 100 patients should never be under the same 

 roof. And less is letter. This has led to the 

 pavilion form of building being adopted blocks 

 connected by corridors. Ttco floors only of patients' 

 wards are admissible, but hospitals with only one 

 floor for the ward accommodation are now univer- 

 sally recognised as l>est. More than three is insani- 

 tary. Hospital buildings consist ( a ) of the wards for 

 the reception of the sick, and their appurtenances ; 

 these necessarily form the basis of the design ; 

 subsidiary to these are the operating theatre. A..-. : 

 and where there is a medical school instructional 

 accessories have to be provided. (6) The build- 

 ings for administration i.e. for lodging the stall', 

 the kitchen, stores, and dispensary, should l>e 

 always subordinate to the question of the accom 

 modation for sick. In some hospitals extra out- 

 patients' departments are provided. These should 

 never be placed under the same roof with the wards 

 for the sick. 



(a (The first principle of the ward unit is that 

 the ward and ward ofhces should be self-contained 

 within one door commanded by the head-nurse's 

 room, so that at anv moment she may know where 

 every patient is. The si/e of the wards has to be 

 somewhat guided by economy of administration, 

 so as to enaule the largest number of patients to be 

 nursed by a given numlier of nurses. The limit of 

 the ward is practically the number who can be 

 efficiently nursed under one head-nurse. Each 

 ward may have subsidiary to it one or two small 

 wards for bad cases. 



The ward appurtenances consist partly of nursing 



