The Express.
London, England, 1868-10-08 00:00:00

NLW IDEAS IN HOSPITAL CONSTRUCTION.

Hitherto our London hospitals, in too many
instances, have been but traps to end,* strong
men to their death. A poor fellow suffering from
fCIIIC sad accident muted by the steam machinery
employed in apiculture] labour is sent up to town
to one of our great hospitals in order that he may
have the advantage of some distinguished opera-
tor's skill ; a mechanic falls down, fractures his
kg, and goes into a famous metropolitan hos-
pital to suffer amputation at the band of some
noted surgeon. The fame of a distinguished name
in the hour of trouble Attracts the maimed and the
wounded, and the friends tatter themselves that

under such distinguished Osre the ease is likely to
do well. But it unfortunately happens that the
skill of the operator is sometimes more than
counterbalanced by the foul and poisonous condi-
tion of the hospital atmosphere in which
ho is called upon to operate. Many ope-
rations that do well in pure country
air are as likely as not to be fatal in the
foul wards of metropolitan hospitals. There may
be no want of cleanliness to the eye, the nose may
detect no foul smells, but yet death may lurk in
every corner of the building, in a sponge, in a
towel, in the air, in the form of hospital gangrene
and pysernia, subtle poisons which frustrate the
utmost skill of the surgeon, and kill the patient
who has submitted to any of the capital opera-
liens. Hospital gangrene, it is true, is the more
especial scourge of naval and military hospitals,
w here large numbers of wounded men are crowded
together ; but to show that civil hospitals are also
liable to attacks of this nature, we may mention
that in 1836 it appeared in Micisllesex Hospital, in
the University College Hospital in 1844, in St. Bar-
tholomew's and St. L:serge sin 1847. There were
seven epidemics, but isolated caste are rarely
absent from any of them. The poison is so subtle
that it speedily marches from ward to ward, and
singles out caste whore extensive operations have
been performed, and the result is generally fatal.
Hitherto the only method of checking its ravages
has been to shut up the infected wards fur a
longer or shorter period perfect isolation
being the only remedy. In the new hospital
now rising beside the embankment at Westmin-
ster-bridge we are beholding a perfect revolution
in all our old ideas respecting hospital architec-
ture. Instead of a huge block, in which is con-
tained all the machinery by means of which such
institutions for the relief of suffering humanity
are carried on, the construction is on the pavilion
system, spread over nearly half a mile of ground.
It is, in short, a collection of hospitals plated lido
by side, each one being perfectly isolated from its
neighbour. Theldts is taken from the famous La
Itelsisivr, in Paris, but it will be more perfect thin
its exemplar. Each pavilion or hospital blo;!:c
will contain four storeys, and each storey will
afford room for 28 beds. These hospitals will bee
125 feet apart, with the exception of the centre
one, which will be separated from the others by •
width of 200 feet. The only means of communi-
cation between these different blocks is afforded by
an open corridor running the whole length of the
building. Thus, if hospital gangrene wens by any
possibility to break out iu any of these blocks,
it would be entirely isolated from the others,
and by no possibility could the epidemic
sweep through the building. The operating theatre
and the dissecting rooms will be entirely apart.
and away from those buildings appropriated
intirely to the cure of disease. The site is admir-
ably chosen. The river, here running due north and
south, will afford a fine western aspect to the
hospital wards, which will be the must cheerful of
any London hospital. Indeed, especial owe has
been taken to afford the patients the weans of
amusing themselves as they lie upon their bed of
suffering. We all know how monotonous is the
hospital life in general, how carefully the windows
are placed so that nothing is to be seen of the
outside world, as though any means of diverting
the patient's thoughts from his suffering waa au
extra, against hospital regulations. All this has
hem slanged in the new St. Thomas's. The
windows are to be plated between each bed, and
patients are to have the luxury of an uninter-
rupted view from ceiling to floor, through
plate-glass, whilst lying in their beds.
Thus all the moving panorama of life,
which at this part of the river is very great,
will be brought before their eyes. Another
extra indulgence will be the coverel balcony over-
looking the river, which the roads with a western
ate eel will open on to. Thus the poorest will have at
their disposal a building possessing better sanitary
arrangements and more perfect ventilation than
any nobleman could command in his town house.
The training institution for the Nightingale nurses
will be placed in buildings apart ; rce disease will
give its aid in educating young sisters for their
future work among the afflicted. This splendid
hospital will be surrounded with 81 sores of grounds
—another vast improvement upon our metropolitan
hospitals. The building will be in the Palladian
style of architecture, and will form a worthy
counterpart to the houses of the le&lature on
the opposite side of the river, and the half-million
of money it will cost will be bestowed upon an
institution that we may be proud to show to
foreign visitors.
Whilst we have done thus much to improve the

condition of metropolitan hospitals, a very great
reform in the same direction has taken place in
country districts. Year by year agriculture is
putting on all the features of a manufacturing
industry. The rude implements of labour we were
accustomed to in our youth have given way to
complicated and dangerous steam appliances ; the
simple flail has culminated in the steam thrashing
machine; the plough is now driven by the same
power ; the winnowing machine is a dangerous
appliance in the hands of the not-too-intelligent
labourer. Hence the greatly increased num-
ber of accidents, some of there of a most
dangerous character, which have taken
place of late years in our country dis-
tricts. But the demand called forth the remedy.
buck cases must be treated speedily or the patient
dies. There is no time to remove him to the next
county institution, the hospital must be brought
to him. As long ago as 1859, this was seen by a
country practitioner—Mr. Albert Nap per, of
Cruidey, in Surrey—who in that year, with the aid
of the vicar of his parish, the Rev. Mr. Sapte,
established a cottage hospital. What was wanted
was a simple house of refuge, situated in the pure
air, where the sufferer could be quickly conveyed
and as quickly treated. Three or four rooms,
looking out upon a little garden, were all that was
needed. One servant for such an establishment
was sufficient for the house work, and ono trained
nurse to attend upon the patients, which in the
original Cranky example consisted of six, making
up as many beds. Like all simple but appropriate
Wises, this village hospital was an immense success.
Not only did patients with desperate wounds get
((pettily well, such indeed as would have most
certainly died in any confined town hospital, but
a new source of occupation was found to dissipate
the ennui of the country. A centre of charity
was created for the neighbourhood, and a
machinery by which all dames were brought
together. This was loon found to be a benefit to
both rich and poor. The latter were delivered
from the agony of a long journey to some distant
hospital, and the former gained by reason of the
skilled surgeons they were, by means of this in-
stitution, breeding up amongst them. Before
these village hospitals were established, the
country was drained of all desperate surgical caws.
for the mean that there were no appliances at
hand to deal with such eases. They were, as a
matter of course, seta to the next town ;
hence the hand of the country surgeon, fur
:St L.;c, ct=115.7.3.7; seed when tilt:2ll4in