The Hospital Roquirements of Sydney. 27 



from various parts of this and other colonies for hospital treat- 

 ment in Sydney, and the nature of our metropolitan and suburban 

 population, I am disposed to afford a much higher proportionate 

 amount of hospital accommodation than that mentioned above. 

 The nearest estimate which I can obtain of the population of the 

 city and suburbs is 121,000, and I venture to recommend 600 

 hospital beds as necessary to meet our present requirements. Of 

 this number, 350 should be provided in Sydney, and 250 in the 

 country branch establishment. Of the latter, 150 would probably 

 be required in the chronic case department, and 100 in the con- 

 valescent wards. The number here calculated for Sydney is sup- 

 posed to be in excess of the actual demand for acute cases and 

 accidents, in order that a sufficient number of clinical and special 

 cases may be accommodated, and that the beds may always be 

 sufficiently numerous to afford full and varied experience to stu- 

 dents of medicine. 



In the following remarks upon the construction of Central 

 General Hospitals I shall endeavour to embody all that it appears 

 desirable to mention in so short a paper as this must necessarily 

 be, leaving only special features of difference to be alluded to, 

 when other and less complete forms of hospitals come under eon- 

 sideration. 



Hospitals not built upon the isolated or pavilion principle are 

 prone to engender hospital disease among the patients, while very 

 large pavilion hospitals extend over an inconveniently large area, 

 involving a great expenditure of labour and time in furnishing 

 the requisite supplies of food, &c, increasing also the difficulty of 

 supervision and management. 



Simplicity of plan and general management being accepted as 

 essential, an hospital should not exceed that size which is capable 

 of possessing a central executive department within easy reach of 

 all its wards. 



It appears to me that under no circumstances should a general 

 hospital be constructed to contain more than from 400 to 500 

 beds, the former being the more desirable, while for all the pur- 

 poses of clinical instruction a well-ordered hospital of the size 

 mentioned will fulfil every object, and in many respects will be 

 preferable to a more extended arena for study. 



The construction of a modern hospital should therefore be upon 

 the isolated or pavilion principle, more or less modified to meet 

 the exigencies of ground, situation, size, &c. 



In a large hospital a separate detached block is required for 

 the administrative accommodation, which it will be convenient to 

 place in a central position, and at right angles to the pavilions. 



In small hospitals the administrative department may occupy the 

 central portion of one line of building, having wings containing 

 the wards extending on either side. 



