2 
be productive of good by increasing tbe utility 
of our Queensland hospitals in tbe greater care 
and more speedy recovery of their sick inmates. 
It cannot be too frequently urged that tliis last 
is the chief aim to which all hospital manage- 
ment should be directed, and the more 
speedily the patients admitted are sent out 
again restored, the greater the success of the 
institution. Hospitals at best are but neces- 
sary evils, and collective care and attention can 
never be the same as individual. Badly con- 
trived and ill-arranged, they are a curse rather 
than a blessing, and tend to destroy rather than 
to preserve human life. In the Crimea it is a 
well ascertained fact that of the sick who were 
placed in bare huts and almost entirely exposed 
to the elements during the fearful winter of 
1854-55, not more than half died of the num- 
ber that perished during the same period 
within that by-word for horror and misery — 
the hospital at Scutari. During the famine in 
Ireland and the fever that followed it, there 
was a marked contra- 1 between the number of 
deaths and cases treated in the open air and 
under hedges, compared with those of the same 
class treated in the workhouses and hospitals. 
In the wooden huts at Balaclava, which 
held from 15 to 30 patients, tbe mortality was 
under 3 per cent, of cases admitted, while at 
Scutari the mortality was 42 7, or nearly 43 
per cent, on the cases admitted. The medical 
men will, I believe, confirm me in saying that 
a patient ill with the small-pox has greater 
chance of recovery in an open shed and lying 
on clean straw than in many hospital wards. 
By the kindness of His Excellency, I have 
been furnished with a copy of the interroga- 
tories issued by the Home Government to all 
the colonies, in the year 1863, on the subject of 
the local institutions for the treatment of the 
sick and insane, and also with a copy of the 
minute drawn up in consequence, and sent in 
reply to the information so obtained. The 
whole tendency of that document goes to prove 
the unmitigated evil arising from the forma- 
tion and management of hospitals on wrong 
and defective principles. On the present occa- 
sion, I must be understood as referring to the 
hospitals and general infirmaries only. The 
subject of lunatic asylums will call for special 
treatment, while there are collateral questions 
of drainage and water supply which we can 
only allude to in passing. In hospital build- 
ing the seeming paradox may be considered as 
holding good, that while economy must be 
rigidly studied, money must, at the same time, 
be the last consideration. If, as will generally 
he the case, funds are but small, it will be 
found better — and the hospital will be more 
successful — if afewer numberof patients are pro- 
vided for, and the building thoroughly complete 
with, all modern improvements and appliances, 
rather than to erect a large building capable of 
bolding a great number of patients at one 
time, and with that aim only, and defi- 
cient in the meaus for speedily restoring 
its inmates to their homes recovered. 
Our first point in founding a hospital must be 
the locality and site. In a new country such 
as our own, we can hardly from circumstances 
do otherwise than place our infirmaries in the 
same relative position as that now held by 
most county hospitals tn the smaller county 
towns — that is, just outside the Municipal boun- 
daries, a position which ha* been proved by 
staiistics to be the most healthy and conve- 
nient. The want of fresh air and of a con- 
stant changb in it is not compensated by close 
proximity to those who require hospital services, 
and thronged thoroughfares or localities liable 
to he built upon should be avoided. On the 
other hand, if outpatient* are to be accommo- 
dated (although it would be often better could 
the two be kept entirely distinct,) the hospital 
must not be placed too far out of reach, so as 
to cause them a tedious or long journey. A 
large area of ground should, if possible, be ac- 
quired, to enable the formation of ga dens and 
airing grounds, and also to rend n* the hos pital 
at all titn j s independent of the surrounding 
locdites should they hereafter become thickly 
inhabited. The ground chosen for the build- 
ing site should be elevated, with a natural fall 
for the sur ace drainage every way ; the soil 
should of course be dry, and if possible 
gravelly or a porous subsoil, but at all events 
neither low nor swampy. Proximity to tidal 
rivers or creeks, where die mud-banks are ex- 
posed at intervals should be carefully avoided, 
as also the neighbourhood of manufactories, 
slaughterhouses, or chemical works. To shew 
that with every precaution ag hast it the influ- 
ence of malaria is often very d ‘trurtive, and the 
proximity of places where it is generated much 
tobeavoided, itis stated of the Lariboisiere Hos- 
pital, in France, on good authority, that a wind 
blowing for a few hours from the direction of a 
malarious quarter of the town was of sufficient 
i ifluence to give a malignant character to pre- 
viously healthy sores. The site chosen, the next 
step is the plan and arrangement ; and several 
requirements apparently conflicting meet us at 
the outset, all demanding more or less atten- 
tion. The chief desiderata in a good hospital 
plan, in England, are sunlight and fresh 
air. Formerly the rule was to exclude 
the light, but it has been proved 
over and over again that with certain excep- 
tions patients recover sooner where the rooms 
are flooded with light, and seldom will a 
physician now as formerly order the blinds of 
a ward or room to be drawn down, but rather 
the reverse. In this country, however, the 
ease is somewhat altered, and although we do 
not require gloom or dullness we cannot be ex- 
posed to the glare and heat of the sun’s direct 
rays. But if we are compelled to exclude the 
sun, a fortiori are we obliged to give every 
facility for the admission of air, of which, so 
long as we avoid drafts and sudden changes. 
