The features of modern hospitals that are most important are the reception rooms and the operating rooms. The reception rooms should provide a special apartment for emer gency operating and all the patient's outdoor clothes should be removed there, transferred immediately to a sterilizing room and then placed in lockers to be kept until the patient needs them on exit. Except in emergency sur gical cases where there is shock, the patient is thoroughly bathed before being dressed in the regular hospital garments and then transferred to the ward. Private Patients are taken directly to their room and cared for on similar prin ciples.
The heart of the modern hospital is the operating room. The supreme ides in the construction of this is cleanliness, though light is a very important secondary consideration. If possible it is built with a northern exposure on the top floor of the hospital both for light and air, as well as that in this situation only those approach it who have business there. It is thus less exposed to the infections that might be brought in from outside. The per fection of artificial light in our day has made the natural lighting problem of ever so much less significance than it was and has facilitated emergency operations at night, even in the receiving ward on the lowest floor, when time is vital. For the sake of surgical cleanliness, the operating room is floored with tile, and the walls for some distance up are made of the same material or of some very hard cement coated with enamel paint that can be thoroughly washed. If there are places for students, these are of limited extent, are made of polished artificial stone or other unabsorbent material with metal railings and usually furnish only Standing space. The old surgical amphitheatres built of wood, whose central arenas after a time must have been quite impossible to clean sur gically, are a thing of the past. Where they are still used, it is only because of the neces sity of teaching large numbers of students and then only for already infected cases. Operating tables have become elaborate apparatus, making it possible to put the patient in any position required, and yet so constructed of polished metal, commonly nickeled, that surgical clean liness is facilitated.
The operating room is connected with a series of rooms for the sterilization and storage of dressings, for the anaesthetizing of patients, which is no longer done in the operating room as before; for the transfer of soiled dressings, and other such material, so as to be sure that the sterilizing room will be saved from all con tact •with possibly infected matters, and some times with temporary rooms for the treatment of shock after the operation, so that patients may not have to be moved far, nor subjected to the almost inevitable draughts of corridors and elevators during removal after the opera tion, until the reaction has begun. The im
provement of the elevator has greatly facili tated hospital work and the ready removal of patients, making the presence of the operating rooms on, the top floor in the warmest part of the hospital possible. Wheel carriages of vari ous kinds add to these facilities so that there is very little of that disturbance in moving patients which was almost inevitable under older conditions.
In the operating room itself, all water con nections are so arranged that they can be turned off and on either by the foot or knee, so that there is never any need for the surgeon or his assistants to touch any object with the hand When once cleansed for operations. Instrument cases, if placed in operating rooms, are now made entirely of glass and metal, though preferably there is a special instrument room. Tables on which instruments and dressings are placed are made of metal and glass, the metal usually finished with white enamel paint, easily cleaned, revealing the slightest trace of dirt.
As an additional precaution the operating, dressing, and instrument tables are covered with sterilized materials just before the opera tion. These are changed between all successive operations. All these apparatus are mounted on casters usually of metal or porcelain so as to facilitate necessary movement by simple touch without the necessity of lifting.
The hospital kitchen has grown greatly in importance, and then there are special diet rooms and apparatus for keeping things warm on each floor or with each ward. These are not directly connected with wards, but open out upon the corridor. The development of bath. ing arrangements in recent years, private baths in connection with many of the private rooms, and a number of baths for ward patients is another important advance of modern times. Corridors of the hospital are usually in slate or tiling with rounded joints to facilitate wash ing at the angles, though artificial stone floors of various kinds have recently been used for this. These are hard on the feet of nurses hence the use of compressed cork which is now coming in.