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6th. That efficient water-closets, ablution, and bathing accommodations should be provided.

7th. That they should be amply supplied with water and gas, or other means of illumination. 8th. That the furniture of all kinds should be of suitable quality.

9th. That the officers and attendants should have their proper respective duties assigned to them, and that they should be in number sufficient for the wants of the sick.

10th. That proper rules should be established for the government of the hospital, for the diet of the inmates, and for preserving order and an efficient state of police.

The idea of a hospital, conceived by most non-professional readers, is that of a huge barrack-looking building or buildings, three or four stories in height, gloomy in appearance, and into whose cavernous walls many a poor unfortunate enters, but very few return to the life and bustle of the outer world. This typical hospital is as far as possible from the conception of Surgeon-General Hammond, or the able medical directors and surgeons who have been his coadjutors in planning and superintending the construction of the General Hospitals of the Army. They started with certain fundamental ideas of construction, which have been carried through all their hospitals. The first of these was ridge ventilation, or the supplying a way of egress for the foul air of the ward by an opening of from ten inches to three feet at the ridge or apex of the roof, protected from the admission of rain, snow, or violent winds by a false roof, raised four inches above the true one, and projecting over it on each side about two feet. A perforated iron plate near the floor and behind each bed admits the fresh air, which passes thus upwards, and forces the foul air through the roof opening. This forms the summer ventilation. In winter the fresh air is admitted around the stove from below, and passing between the stove and an outer casing of zinc, which surrounds it, is distributed through the room; while a large, square wooden tube open at the bottom, and extending to the roof, receives and encloses the pipe of the stove to its termination above the ridge, and thus becomes the ventilator of that portion of the ward.

Another new feature in the construction of these hospitals was the entire separation of the wards from the administrative portion of the hospital, and the making of each ward a single one story pavilion, removed so far from every other ward or building, that it could have the benefit of the sun, and the free circulation of pure air on both sides of it, throughout the day, while at the same time one end of each ward opened from a corridor which would serve as a covered hall for exercise to the convalescing patients, and through which there was communication with the administrative buildings. The pavilions were to have their long diameter, where possible, a north and south line. An

other point insisted upon was that no patient should have less than 1,000 (except under very peculiar circumstances not less than 1,200) cubio feet of space, and the air of this, by the system of ventilation, constantly changing.

The pavilions were to be raised at least one foot, generally two, above the ground; the floors to be coated with a mixture of beeswax and oil, to prevent any liquid from soaking into them; the baths and water closets to be at the extreme end of the pavilions, and form an angle with them, and to be connected with such a system of sewerage as would convey all offensive matters and odors away instantly. A ward or pavilion was not to contain more than fifty-two beds, and these were to be placed in pairs with three feet space between the two, and each pair to be placed between the windows; the two beds occupying an average space of fifteen feet in the length of the ward, and of seven and a half feet in width, and a passage way of ten feet to extend through the middle of the ward for its whole length, thus making the width of each ward twenty-five feet, and its length, if it contains fifty-two beds, about two hundred and twenty feet; the additional twenty-five feet being occupied with water closets, scullery, &c., at one end, and wardmasters', nurses' rooms, and mess room at the other. In the practical application of these principles, it has been found better not to have the wards quite so long, and they generally contain only thirty-six or forty-eight beds (some only twenty-four); or, if there are fifty-two, they occupy somewhat less than fifteen feet to the pair. The first large hospital built upon the principles presented by the surgeon-general, was the West Philadelphia Hospital, situated at the intersection of Forty-fourth and Spruce streets, half a mile outside of the limits of the city of Philadelphia. We subjoin an engraving (fig. 1) of the general plan. The corridors are each 860 feet long, 14 feet wide, and 13 feet high, and serve as mess rooms for the pavilion. There are 34 pavilions, b b b, each 24 feet wide, and 13 feet high at the eaves; they are now of unequal length, ranging from 150 to 250 feet. Between the corridors is the administrative building, a. There are three kitchens, ccc; two laundries, dd; a chapel, e; store rooms, ff; a mess room for special occasions, g; two buildings for officers' quarters, hh; boiler room, i; residence of surgeon in charge, k; water tanks, 7; barber shop and printing office, m and n; boiler and tank, o; smoking rooms, pp; reading and lecture room, q; knapsack room, r; guard room, 8; stable, t; guard, u. The pavilions are 21 feet apart, which is too close by at least ten feet. The building is of wood, lathed and plastered on the outside. Its cost, aside from furniture, exceeded $200,000. It has 3,124 beds. The number of medical officers is fifty-two, beside eighteen medical cadets, and of cooks, nurses, and other attendants, four hundred and sixtyfour. There are also three chaplains.

A still finer example of a great military hospital, the largest in the world, is the Mower General Hospital, at Chestnut Hill, Philadel

phia. This vast establishment consists of 50 pavilions, each 175 feet long, 20 wide, exclusive of the water closet and scullery which (FIG. 1.)

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GROUND-PLAN OF WEST PHILADELPHIA HOSPITAL.

project from the pavilion, 14 feet high to the eaves, and 19 feet to the ridge. These pavilions project in radii from a corridor of flat

tened ellipsoidal form, 16 feet wide, and 2,400 feet long, enclosing an area of 541,466 square feet. Across the shorter diameter of the ellip

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a ward pavilion in detail: a is the ward room, occupying 150 feet in length of the pavilion, and twenty feet wide, containing fifty-two beds; b, the mess room; c, scullery; d, bath room; e, water closet; f, ablution room; g, wardmaster's room. The pavilions are four or five feet narrower than they should be, and when the beds are all full there are but 960 cubic feet of air to each patient; but as this is constantly changed by the admirable ventilation, it is nearly sufficient. The number of beds is 3,320. There is a force of 622 officers, attendants, guard, &c., attached to the hospital. The cost of the buildings was over $250,000. The McClellan Hospital, situated in the neighborhood of Philadelphia, though smaller (1,040 beds), is, perhaps, more nearly perfect than any other yet erected. The corridor is of a flattened ovoidal form, from the ends of which the pavilions project. These pavilions are wider, larger, and farther apart than at the Mower Hospital. The administrative building is in the centre and connected with the corridor by two straight passage ways. In the ground-plan (fig. 3), a is the main corridor; bbb, wards; c, administrative building, two stories high; d, kitchen; e, laundry; f, clothing and guard rooms; g, engine room; h, stable; i, provision and knapsack store room; k, quarters of medical officers in charge.

We give below ground-plans of two other military hospitals of large size, each arranging the pavilions in a different way, but all observing the same principles. The first is the Hammond General Hospital, at Point Lookout (fig. 4), in which sixteen pavilions project from a circular corridor. The administrative building is the wide structure at the upper side of the circle, and the kitchen, laundry, guard room, dead house, &c., are in the centre. The pavilions here are 40 feet apart at the corridor, and 75

feet at the farther end. They are 145 feet long, 25 feet wide, and 14 feet high to the eaves, and 18 to the ridge. The ventilation is perfect. Each patient has 1,116 cubic feet of space. The second, the Lincoln General Hospital, at Washington city (fig. 5), has its pavilions placed en echelon, along a corridor, forming two sides of an acute-angled triangle. The administrative building is at the apex, and the kitchen, &c., inclosed within the angle. This hospital accommodates 1,200 patients. By this arrangement a thorough ventilation of each ward is secured, while all the wards have the same direction and receive the rays of the sun at the same time-a matter of considerable importance.

In the West, large hospitals on some one of these, or similar plans, have been erected at St. Louis, Louisville, Nashville, Madison, Evansville, and New Albany, Indiana; and others are building at Madison, Wisconsin; Davenport, Iowa; and other points.

For field hospitals, the hospital tent is undoubtedly preferable to any building. Where a camp is somewhat permanent, the improved Crimean tent with double walls, ridge ventilation, and the admission of pure air near the floor, answers a good purpose. In both, special attention should be paid to ventilation, and over-crowding carefully avoided.

In the lighting and warming of hospitals, special care is now taken to avoid vitiating the air by the gases produced by combustion. Where it is possible, illuminating gas is used, but the vitiated air, and carbonic acid gas, are conducted off by chimneys in such a way as to increase the ventilation of the ward. cannot be obtained, the vegetable oils or paraffine, spermaceti, or wax candles are preferable to any other modes of illumination. Coal or petroleum oils, camphene and burning fluid, ir

If gas

(FIG. 8.)

M'CLELLAN HOSPITAL, PHILADELPHIA,

ritate the lungs, and affect the respiration. The animal oils give off carbon, carbonic acid, and carburetted hydrogen in too large quantity to be desirable. The heating of the hospital wards should be connected as far as possible with the ventilation. The usual method is by stoves, though in some, hot water is introduced with advantage. Ruttan's system would seem to possess advantages over any other plan of warming and ventilation, but, so far as we are aware, has not been introduced. The temperature in cold weather is carefully watched, and

is not allowed to vary much from 64° to 66° Fahrenheit.

The alimentation of the soldier is one of the most important items in the hygienic condition of the army. Great attention has been paid by the medical and commissary officers of the Government, to the arrangement and character of the ration, in order to furnish such combinations of food, and of such quality, as should be best adapted to maintain the health and strength of the soldier in its greatest perfection. The rations of most of the European armies are de(FIG. 4.)

GROUND-PLAN OF HAMMOND GENERAL HOSPITAL, POINT LOOKOUT.

fective in these respects. The quantity of meat is generally too low, and in some, the supply of fresh meat and vegetables, and of coffee and sugar, is altogether inadequate. The fearful prevalence of typhus fevers, and of scurvy and other cachectic diseases, in the British and French armies in the Crimean war, was unquestionably owing to the poor quality and scanty quantity of the rations. The British soldier receives at home stations sixteen ounces of bread, and twelve ounces of flesh meat uncooked; on foreign stations, sixteen ounces of bread, or twelve ounces of biscuit, and sixteen ounces of meat, fresh or salt. This is charged

to him at three and a half pence per day abroad, or four and a half pence per day at home. Coffee, sugar, pepper, potatoes, salt, or whatever else he may need, he must purchase from his own funds, where and how he can. In a few of the foreign stations, as at Hong Kong and the Cape of Good Hope, rice, sugar, coffee, and salt, in insufficient quantities, are issued as component parts of the ration. In the United States army, the ration is wholly independent of the pay, and consists of the following articles: bread or flour, 1 lb. 6 oz.; fresh and salt beef, 1 lb. 4 oz., or pork or bacon, 12 oz.; potatoes, 1 lb. three times a week; rice, 1

oz.;

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