May 18, 1900.] 



SCIENCE. 



715 



mum and that he must lose himself in the 

 effort to think wisely and judge well for 

 others. 



In former times, not many years ago, the 

 bedside teaching was provided under a 

 system corresponding to that of apprentice- 

 ship in trade, and the student gained his 

 clinical experience through association with 

 some active general practitioner ; but to- 

 day, with the aggregation of population in 

 cities and the consequent establishment of 

 hospitals, these institutions are made to 

 furnish the clinical material necessary for 

 instruction, thus fulfilling one of their im- 

 portant obligations to the community which 

 supports them ; for while the first purpose 

 of the hospital is to provide for the care of 

 the sick, no such institution does the just 

 measure of its work unless its benefits ex- 

 tend beyond its walls through the education 

 of those whose lives are to be pledged not 

 only to a warfare against disease, but to an 

 efforb toward its prevention. 



From an economic standpoint the hos- 

 pital may be defined as an institution in 

 which capital and skilled labor combine to 

 provide such members of the community as 

 are temporarily disabled and without means 

 of support, with the maintenance and care 

 which shall fit them to become again self- 

 supporting and active community fact- 

 ors. 



It is a free repair shop for human ma- 

 chines, and the capitalist who contributes 

 to its support does so with the basal, though 

 perhaps not with the defined understand- 

 ing, that his contribution is returned to him, 

 through the community, in the lesser num- 

 ber of incapacitated and dependent ma- 

 chines, while the physician who furnishes 

 the skilled-labor contribution finds his re- 

 turn not only in the same manner as the 

 capitalist, but in the opportunity which is 

 given him of fulfilling his duty to humanity 

 with less expenditure than if he did it at 

 his own charge, and with better effect, under 



conditions which inure greatly to his own 

 well-being and usefulness. 



But the hospital of to-day is something 

 very much more than a mere repair shop ; 

 it is a school full of object-lessons in the 

 application of those qualities which are the 

 uprights, the girders, and the binding-rods 

 of the modern social structure. In the first 

 place, it is the most absolutely clean of all 

 human habitations, and the present splendid 

 successes of surgery in the amelioration of 

 suffering and the preservation of life are 

 due not only to the application of trained 

 skill and intelligence, but to its operations 

 under conditions of absolute sterilization 

 which are microscopic in their minuteness. 



Not only is the hospital a lesson in phy- 

 sical cleanliness, but, if justly administered, 

 it is morally clean as well ; for so important 

 is its service, so often does the issue of a life 

 depend upon the observance of some ap- 

 parently minor detail, that its work must 

 be done under the strictest discipline ; 

 order, obedience, alertness and complete 

 devotion to the duty in hand must be com- 

 manded within its walls. 



Under such responsibilities the position 

 of superintendent of a hospital is a serious 

 one, calling for administrative ability of no 

 m.ean order. 



Gradually with the growth of urban hos- 

 pitals these posts have come to be filled by 

 selected men who, from previous education, 

 along other than medical lines, or from 

 training in the hospitals themselves, have 

 acquired the ability to deal with questions 

 of structure, repair, lighting, heating, ven- 

 tilation, equipment, food-supply, and the 

 details having to do with a housekeeping 

 for hundreds of patients and nearly hal 

 that number, the usual ratio, of medica 

 house-ofiicers, nurses, and attendants. 



Many hospitals are administered by 

 women who have had their preliminary 

 training in such institutions as nurses ; 

 women are also supplementing the general 



