The Hospital Requirements of Sydney. 49 



way fare prevented the patients being visited by their friends. 

 Yet the change in the class of cases is manifest, as is also the in- 

 creased pressure upon the beds of G-uy's Hospital. Now in 

 any scheme for a country hospital to receive the patients of a city, 

 there must always be left in a city a depot for the acute cases and 

 grave accidents not admitting of the transit. 



" The pressure upon the resources of this latter would there- 

 fore increase ; and above all, if fever were received, there 

 would be much risk of it becoming a fever-house only, or only a 

 fever-house with a separate department for accidents. The 

 country department would then become what our country infirm- 

 aries now too often are, viz., a receptacle for chronic invalids ; 

 and the acute non-febrile cases would be left without hospital 

 accommodation. This would be a very grave evil, nor is it easy 

 to be satisfied, from our investigations, that it would be compen- 

 sated by any corresponding benefit. If it seems probable that 

 hospital diseases are relatively as common, and recovery neither 

 more certain nor more speedy in the country than in the town, 

 to what purpose should the hospital be moved and its existence as 

 a school of medicine and surgery thereby endangered ? 



" There is, however, another view of the question, which is well 

 worth consideration, and which we are glad to say is now obtain- 

 ing the prospect of practical experiment, viz., the advantages to 

 be derived from attaching a country department to a large Lon- 

 don hospital, partly as a subsidiary hospital and partly as a con- 

 valescent charity. 



" The effect of this would probably be not only different from 

 but even opposite to that of removing the bulk of the hospital 

 into the country, and leaving only a small receiving house in 

 town ; for patients, knowing that they would have the option of 

 remaining in town if they choose, would of course be attracted by 

 the offered alternative of a gratuitous sojourn in the country. 



" Again, the opportunity of sending away from the metropolitan 

 hospital a large portion of the less urgent cases would enable the 

 governing body of the hospital to relieve the same number of 

 patients, with a considerable diminution of the number of beds in 

 the chief hospital. Now if our hospitals present one defect more 

 conspicuous than another to the eyes of the attentive observer, it 

 is that of overcrowding. We believe that at most hospitals 

 (metropolitan and rural, particularly the latter) the beds are too 

 close together. The proposed scheme would give an opportunity 

 to remedy this defect, while it would withdraw the less seriously 

 affected patients from the influence of the hospital diseases which 

 prevail among a number of severe surgical cases, and of the 

 fevers which most of our metropolitan hospitals admit. On every 

 ground we think the experiment well worthy of a trial, and we 

 have much pleasure in quoting from a report issued by a com- 



