No part of the social economy of European countries is so perfect in its organization, so purely numane, and so unobjectionable on the score of promiscuous charity. as the institution of public hospitals or infirmaries. As means of relief and schools of medi cine, they appear to be absolutely essential to every dense community; not the least of their valuable qualities being that, by their prompt and liberal action, they interpose to stein contagious distempers which, if unchecked on their outbreak, might visit and deci mate families who arc far removed above the need of gratuitous medical attendance. On this latter ground, as well as from sentiments of benevolence, the hospitals or infirmaries of England, Scotland, and Ireland are the objects of much solicitude to the general com munity; it being customary for wealthy individuals to bequeath sums towards their sup port., and for public subscriptions and church collections to fie made for them annually. In some cases, besides the infirmaries so miscellaneously sustained, hospitals are erected and maintained wholly by endowment.
A leading peculiarity of medical hospitals is their good order and cleanliness. They are mostly large edifices, and though, in a sanitary point of view, best placed in airy situations, they are for the sake of convenience usually situated in the neighborhoods where they are particularly required. Internally they are arranged in wards. each under its own nurses, with general superintendents and a suitable body of servants. Being open night and day to receive pressing cases, there is a resident surgeon with assistants constantly in attendance. Scrupulous cleanliness, quiet, decorous conduct, exclusion of intoxicants and of miscellaneous visitors, are among the points principally attended to by the managers.
The Middlesex hospital, parish of Marylebone, may he taken as a fair specimen of a general hospital in England. It is a large building, disposed in the form of the letter II, which admits of thorough ventilation in all the passages. It comprehends 310 beds. of which 120 are for medical and 190 for surgical cases. Three wards are set apart for the reception of M poor women affected with cancer, a class of cases when seemingly incu rable not usually admitted into general hospitals. The staff consists of three physicians, who take charge of the medical cases in the wards; a physician-accouchenr•who devotes himself to the diseases peculiar to women and infants. and who superintends the work ing of the maternity department; four surgeons, who take charge of the surgical patients; an assistant physicians and surgeons, who take care of out-patients. Resident house
surgeons and an apothecary with assistants attend to all emergencies in the absence of physicians and surgeons, and summon them if necessary. Attached to the hospital are a chaplain and secretary. The physicians and surgeons, who give their services gratui tously, act as professors in the medical college. The management is conducted h• gov ernors and a medical and weekly committee. In- and outdoor patients are admitted by letters of recommendation from governors or subscribers to the funds, but in cases of cancer and diseases of the eye, and in cases of emergency, the recommendation is dis pensed with. The annual number of patients received into the hospital is about 2,100, and 18,000 receive attendance at their own homes. No lying-in patients are now admit ted into the hospital, but about 800 poor women are yearly delivered at their own dwell ings, by pupils and midwives, under the direction of the physician-accoucheur. The total expense incurred is less than £11,000, of which more than a half is from endow ment, and the remainder from subscriptions, donations, legacies, and miscellaneous col lections. A separate fund is provided to assist poor patients leaving the hospital who may be deficient in clothing or other necessaries.
As in some degree allied or auxiliary to hospitals, there ore two kinds of establish ments deserving notice. The first to be mentioned are public dispensaries, where, at stated hours, medical advice and medicines are given gratis to applicants; and though like other forms of charily liable to abuse, it is allowed that these institutions are of much value in the midst of poor communities, and also, like hospitals, are a means of staying the course of contagions distempers. The other institutions to be noticed are those called in France ?masons de sante. These establishments are private hospitals for the reception and treatment of patients who are able and disposed to pay a small sum for board and medical or surgical attendance. A common charge is from three to five francs a day. Under the name of sanatorium, an attempt has been made to introduce this kind of insti tution into England, where, however, from various circumstances, including the gener ally good home-accommodation of the middle and sub-middle classes, the institution has not become so popular as it is in Paris.