808 



SCIENCE. 



[N. S. Vol. XVII. No. 438. 



men; and though seemingly a serious loss 

 to the city consultant, it is in the end an 

 advantage, as he must prove his better 

 metal in the higher scientific fields and be, 

 as well as seem to be, the better man. 



Moreover, the trustees of every hospital 

 should see to it that a good library and 

 laboratory are provided. Insensibly the 

 staff will read more and more. A single 

 restless, progressive spirit, even though it 

 be a young interne, calling attention to 

 this ease and to that, in one journal or 

 another, will compel the rest of the staff 

 to read in spite of themselves. It is abso- 

 lutely clear that a laboratory with modern 

 equipment for bacteriological, pathological 

 and chemical research in its examination 

 of tumors, of the urine, the sputum, the 

 feces, the blood, the pus, and other fluids 

 from wounds, etc., is a necessity in every 

 hospital. Even many of our smaller hos- 

 pitals are equipped with microscope and 

 reagents if not with a complete bacteriolog- 

 ical outfit, which nowadays is inexpensive 

 and imperative. All of this raises the in- 

 tellectual and professional standard of the 

 stafP. I venture to say that no town of 

 20,000 people can afford to be without its 

 hospital for the sake of its own citizens, 

 utterly irrespective of the good it does to 

 the poor who are treated in its wards. It 

 must be established in the interest of the 

 well-to-do citizens and their families, so 

 that they may secure better equipped doc- 

 tors for themselves as well as for the 

 patients in their hospital. Self-interest, 

 therefore, will compel every community to 

 establish its hospital, even if charitable 

 motives had no influence. 



Again, the trustees of all hospitals of 

 any size should establish a training school 

 for nurses. Only those who, like myself, 

 have lived in the period before such train- 

 ing schools were established, can appreciate 

 the vast improvement effected in a hospital 



by this change. To replace the former 

 ignorant, untrained attendants by ' trained 

 nurses whose jaunty caps and pretty uni- 

 forms and often winsome faces almost 

 make one half wish to be sick, and when 

 one is sick, half loath to be well,' is not 

 only a boon to the patients but to the 

 doctors as well. The intelligent, well- 

 trained nurse, who is on the alert to ob- 

 serve every important change of symptoms-, 

 and who will keep acciirate bedside notes,, 

 is the doctor's right hand. Not a few 

 patients who would otherwise lose heart 

 and hope are, one may say, lured back to^ 

 health and happiness by the tactful atten- 

 tions and restful but efficient care of such 

 a nurse. The commiinity of the well-to-do 

 also are benefited, because the hospital pro- 

 vides them with skilled nurses in their 

 homes when they are so unfortunate as to 

 be compelled to remain there instead of 

 going to the hospital. 



The old repugnance to entering a hos- 

 pital when sick or when an operation is. 

 demanded is rapidly fading away. The 

 immense advantages of a good hospital over 

 the most luxurious home are now acknowl- 

 edged on all hands. The poorest patient, 

 in a hospital is better cared for, his case 

 more carefully investigated by bacterio- 

 logical, chemical and clinical methods in a 

 hospital, than are the well-to-do in their 

 own homes. Indeed, wise surgeons, except 

 in cases of emergency, now very properly 

 refuse to do operations in homes instead 

 of in hospitals. In many instances lives, 

 that would be lost in homes are saved in 

 hospitals, where the many and complex 

 modern appliances for every surgical em- 

 ergency are provided. 



The hospitals in direct or indirect con- 

 nection with medical schools, however, do 

 a far larger work than merely the train- 

 ing of their own staffs of doctors. They 

 train three other classes of doctors : First, , 



