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HOSPITAL (Lat. haspitalis, the adject...

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Originally appearing in Volume V13, Page 801 of the 1911 Encyclopedia Britannica.
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HOSPITAL (See also:Lat. haspitalis, the See also:adjective of hospes, See also:host or See also:guest)  , a See also:term now in See also:general use for institutions in which medical treatment is given to the sick or injured . The See also:place where a See also:guest was received was in See also:Lat. See also:hospitium (Fr. See also:hospice), but the terms hospitalis (sc. domus), hospitale (sc. cubiculum) and hospitalia (sc. cubicula) came into use in the same sense . Hence were derived on the one See also:hand the Fr. See also:hospital, hopilal, applied to establishments for temporary occupation by the sick for the purpose of medical treatment, and hospice to places for permanent occupation by the poor, infirm, incurable or insane; on the other, the See also:form hotel, which became restricted (except in the See also:case of hotel-Dien) to private or public dwelling-houses for See also:ordinary occupation . In See also:English, while " See also:hostel " retained the earlier sense and " hotel " has become confined to that of a See also:superior See also:inn (q.v.), ." hospital " was used both in the sense of a permanent See also:retreat for the poor infirm or for the insane, and also for a See also:regular institution for the temporary reception of sick cases; but See also:modern usage has gradually restricted it mainly to the latter, other words, such as See also:almshouse and See also:asylum, being preferred in the former cases . The Origin of Hospitals.— In spite of contrary opinions the germ of the hospital See also:system may be seen in pre-See also:Christian times (see CHARITY AND CHARITIES) . See also:Pinel goes so far as to declare that there were asylums distinctly set apart for the insane in the temples of See also:Saturn in See also:ancient See also:Egypt . But this is probably an exaggeration, the real See also:historical facts pointing to the existence of medical See also:schools in connexion with the temples generally, to the knowledge that the priests possessed what medical See also:science existed, and finally to the rite of " See also:Incubation," which involved the visit of sick persons to the See also:temple, in the shade of which they slept, that the See also:god might inform them by dreams of the treatment they ought to follow . The temples of Saturn are known to have existed some 4000 years before See also:Christ; and that those temples were medical schools in their earliest form is beyond question . The See also:reason why no records of these temples have survived is due to the fact that they were destroyed in a religious revolution which swept away the very name of Saturn from the monuments in the See also:country . See also:Professor Georg See also:Ebers of See also:Leipzig, whose See also:possession of that important handbook of See also:Egyptian See also:medicine called the See also:Papyrus Ebers constitutes him an authority, says the See also:Heliopolis certainly had a clinic See also:united to the temple . The temples of See also:Dendera, See also:Thebes and See also:Memphis, are other examples . Those See also:early medical See also:works, the Books of See also:Hermes, were preserved in the shrines .

Patients coming to them paid contributions to the priests . The most famous temples in See also:

Greece for the cure of disease were those of See also:Aesculapius at See also:Cos and Trikka, while others at See also:Rhodes, See also:Cnidus, See also:Pergamum and See also:Epidaurus were less known but frequented . Thus it is clear that both in Egypt and in Greece the See also:custom of laying the sick in the precincts of the temples was a See also:national practice . See also:Alexandria again was a famous medical centre . Before describing the See also:European growth of the hospital system in modern times, to which its development in the See also:Roman See also:Empire is the natural introduction, it will be well to dispose very briefly of the facts See also:relating to the hospital system in the See also:East . See also:Harun al-Rashid (A.D . 763–809) attached a See also:college to every See also:mosque, and to that again a hospital . He placed at See also:Bagdad an asylum for the insane open to all believers; and there was a large number of public infirmaries for the sick without See also:payment in that See also:city . See also:Benjamin, the Jewish traveller, notes an efficient See also:scheme for the reception of the sick in A.D.1173, which had See also:long been in existence . The Buddhists no less than the Mahommedanshad their hospitals, and as early as 26o B.C. the See also:emperor See also:Asoka founded the many hospitals of which Hindustan could then boast . The one at See also:Surat, made famous by travellers, and considered to have been built under the emperor's second See also:edict, is still in existence . These hospitals contained See also:provision so extensive as to be quite comparable to modern institutions .

In See also:

China the only records that remain are those of books of very early date dealing with the theory of medicine . To return to See also:India, the hospitals of Asoka were swept away by a revival of See also:Brahmanism, and a See also:practical See also:hiatus exists between the hospitals he introduced and those that were refounded by the See also:British ascendancy . See also:Hadrian's reign contains the first See also:notice of a military hospital in See also:Rome . At the beginning of the Christian era we hear of the existence of open surgeries (of various See also:price and reputation), the specialization of the medical profession, and the presence of See also:women practitioners, often as obstetricians . Iatria, or tabernae-medicae, are described by See also:Galen and Placetus: many towns built them at their own cost . These iatria attended almost entirely to out-patients, and the system of medicine fostered by them continued without much development down to the See also:middle of the 18th See also:century . It is to be noted that these out-patients paid reasonable fees . In Christian days no establishments were founded for the See also:relief of the sick till the See also:time of See also:Constantine . A See also:law of Justinian referring to various institutions connected with the See also:church mentions among them the Nosocomia, which correspond to our See also:idea of hospitals . In A.D . 370 See also:Basil had one built for lepers at Caesarea . St See also:Chrysostom founded a hospital at See also:Constantinople .

At Alexandria an See also:

order of 600 Parabolani attended to the sick, being chosen for the purpose for their experience by the See also:prelate of the city (A.D . 416) . Fabiola, a See also:rich Roman See also:lady, founded the first hospital at Rome possessed of a convalescent See also:home in the country . She even became a See also:nurse herself . St See also:Augustine founded one at his see of See also:Hippo . These Nosocomia See also:fell indeed almost entirely into the hands of the church, which supported them by its revenues when necessary and controlled their See also:administration . See also:Salerno became famous as a school of medicine; its rosiest days were between A.D. r000 and 1050 . See also:Frederick II. prescribed the course for students there, and founded a See also:rival school at See also:Naples . At this See also:period the connexion between monasteries and hospitals becomes a marked one . The crusaders also created another See also:bond between the church and hospital development, as the route they traversed was marked by such See also:foundations . Lepers were some of the earliest patients for whom a specialized treatment was recognized, and in 1118 a leprosarium was built in See also:London for See also:isolation purposes . See also:Russia seems the one country where the interconnexion of hospital and monastery was not to be observed .

After the period already reached, the 13th century, hospitals became See also:

common enough to demand individual or at any See also:rate national treatment . See also:History of the Hospital See also:Movement.—We have now to consider the principles upon which the provision of the best form of medical care in hospitals can be secured for all classes of See also:people . Though hospitals cannot be claimed as a See also:direct result of See also:Christianity, no doubt it softened the relations between men, and gradually tended to instil humanitarian views and to make them popular with the civilized peoples of the See also:world . These principles, as See also:civilization See also:grew, See also:education improved, and the tastes and requirements of the common people were See also:developed, made men and women of many races realize that the treatment of disease in buildings set apart exclusively for the care of the sick was, in fact, a See also:necessity in See also:urban districts . The See also:establishment of a hospital freed the streets of the abuses attendant upon beggars and other poor creatures, who made their ailments the See also:chief ground of See also:appeal for See also:alms . As the knowledge of See also:hygiene and of the See also:doctrine of cleanliness and purity in regard not only to dwellings and towns, but also in relation to See also:food of all descriptions, including See also:water, became known and appreciated, hospitals were found to be of even greater importance, if that is possible, to the healthy in crowded communities, than to the sick . It took many centuries before See also:sound hygiene really began to occupy the position of importance which it is now known to possess, not only in regard to the treatment and cure of disease, but to its prevention and eradication . • So the history of the world shows, that, whereas a few of the larger towns in most countries contained hospitals of sorts, up to and including the middle ages, it was not until the commencement of the 18th century that inhabitants of important but relatively small towns of from 50,000 to 100,000 inhabitants began to provide themselves with a hospital for the care of the sick . Thus, twenty-three of the See also:principal English counties appear to have had no general hospital See also:prior to 1710, while London itself at that date, so See also:fat as the relief of the sick was concerned, was mainly, if not entirely, dependent upon St See also:Bartholomew's and St See also:Thomas's Hospitals . These facts are interesting to See also:note, because we are enabled from them to deduce from See also:recent events that hospital buildings in the past, though the planning of most of them was faulty to begin with and became more and more faulty as extensions were added to the See also:original buildings, did in fact suffice to satisfy the requirements of the medical profession for nearly two centuries . In other words, under the old See also:condition of affairs the See also:life of a See also:building devoted to the care of the sick might be considered as at least 150 years . To-See also:day, under the conditions which modern science impose upon the management, probably few hospital buildings are likely to be regarded as efficient for the purpose of treating the sick for more than from 30 to 5o years .

The foregoing statement is based upon the history of British hospitals of importance throughout the country, but the same remark will apply in practice to hospital buildings almost everywhere throughout the world . In truth, hospitals have been more developed and improved in See also:

Great See also:Britain than in other countries, though, since the last See also:quarter of the loth century, See also:German scientists especially have added much to the efficiency of the See also:accommodation for the sick, not only at hospitals but in private clinics, and many German ideas have been accepted and copied by other countries . In Great Britain hospitals for the treatment of general and See also:special diseases are mainly maintained upon what is known as the voluntary system . On the European See also:continent, hospitals as a See also:rule are maintained by the See also:state or municipalities, and this system is so fully developed in See also:Sweden and elsewhere that a sound economical principle has been embroidered upon the hospital system, to the great See also:physical and moral See also:advantage of all classes of the community . The system referred to confers great benefits upon inhabitants in large towns by bringing the poor-law and voluntary institutions into moreintimate association, although they may be managed by See also:separate governing bodies . The See also:plan pursued is to demand payment from all patients who are admitted to the hospital under a See also:scale of charges divided into three or four grades . The first grade pays a substantial sum and obtains anything or everything the patient may care to have or to pay for, subject to the See also:control of the medical attendant . The second pays much less, but a remunerative rate, for all they receive at the hospital; and the third and See also:fourth classes are very poor people or paupers, who are paid for on a graduated scale by the poor-law authorities, or the communal See also:government, or the See also:municipality . Under this system well-to-do thrifty artisans and improvident paupers are all treated by one See also:staff, controlled by one administration, and are located in immediate proximity to each other though in separate pavilions . We have no doubt, as the result of many years' investigation and an accurate knowledge of the working of the system, that this is the true principle to enforce in providing adequate medical relief for large urban populations everywhere throughout the world . It should be accompanied by a system of government See also:insurance, whereby all classes who See also:desire to be thrifty may pay a small See also:annual See also:premium in the days of See also:health, and secure adequate hospital treatment and care when See also:ill . Provided that pay wings were added to the existing voluntary and municipal hospitals, it should be found that the relatively small annual premium of 3 per annum should enable the policyholders to defray the cost of medical treatment in a pay See also:ward or at a consultation See also:department of a great hospital as a See also:matter of business .

In the United States of See also:

America most large towns have great hospitals, usually known as city hospitals, administered and mainly supported by the municipality . Many such institutions have pay wards, but nowhere, so far as we have been able to discover, has the system of medical relief in its entirety been organized as yet upon the business system we have just referred to . As to the relative merits and demerits of the systems of government of municipal hospitals and voluntary hospitals a few words may be useful . There can be no doubt that the voluntary hospital in Great Britain has had a remarkable effect for See also:good upon all classes in the making of modern See also:England . The management of these institutions is frequently representative of all classes of the people, while the voluntary system, as the Hospital See also:Sunday collections all over the country, and all over the English-speaking world, prove, has united all See also:creeds in the good See also:work of caring and providing for the sick and injured members of each community . Again the voluntary system makes for efficiency in the administration of all hospitals . Each voluntary hospital is dependent upon its popularity and efficiency, in large measure, for the See also:financial support it receives . In this way an ill-managed voluntary hospital, or one which has ceased to fulfil any useful public purpose, is sure to disappear in due course under the voluntary system . Voluntary hospitals are always open to, as well as supported by, the public, and, owing largely to the example so prominently set by See also:King See also:Edward VII. and members of the royal See also:family, more people every See also:year devote some time in some way to the cause of the hospitals . Attached to the voluntary hospitals are the principal medical and See also:nursing schools upon which the public depend for the See also:supply of doctors and nurses . The education of students and nurses in a clinical hospital makes that hospital the most desirable place for every-See also:body when they are really ill . In such a hospital no patient can be overlooked, no wrong or imperfect diagnosis can long remain undiscovered and unrectified, and nowhere else have the patients so continuous a See also:guarantee that the treatment they receive will be of the best, while the provision made for their comfort and welfare, owing to the unceasing and ever varying quality of the See also:criticism to which the work of everybody, from the See also:senior physician to the humblest See also:official, is subjected in a clinical hospital, is unequalled anywhere else .

At a great voluntary hospital, not only do hundreds of medical students and nurses work in the wards, but thousands of people, in the persons of the patients' See also:

friends, and those members of the public who take an See also:interest in hospitals, pass through the wards in the course of every year . Again, each voluntary hospital has to live by competition, a fact which guarantees that everything in the way of new treatment and scientific development shall in due course find its proper place within the walls of such an establishment . Open as they are to the full inspection of everybody whose knowledge and presence can promote efficiency, the voluntary hospitals have shown, especially since the last quarter of the 19th century, a continuous development and improvement . Here the patients are treated with invariable kindness and See also:consideration, as human beings rather than cases, to the great benefit of the whole human family as represented by the officials, the patients and the students, with their relations and friends, the honorary medical See also:officers, hundreds of medical practitioners and nurses, who receive their medical training in the hospitals, and the ever-increasing number of See also:governors and supporters by whose contributions voluntary hospitals live . The great missionary and social value of the voluntary hospitals to the whole community cannot be questioned, and they have been of inestimable value to the churches by inculcating the higher principles of humanity, while removing the many acerbities which might otherwise prevail between rich and poor in large cities . The voluntary hospitals are attended, however, by certain disadvantages which do not attach to municipal institutions . A municipality which undertakes the provision of hospitals for the entire community is largely able to plan out the urban See also:area, and to provide that each hospital site selected shall not only be suitable for the purpose, but that it shall be so chosen as to contribute to make the whole system of hospital provision easily accessible to all classes who may require its aid . The voluntary hospitals, on the contrary, have grown up without any comprehensive plan of the districts or any real regard to the convenience or necessities of their poorer inhabitants . Voluntary hospital sites were almost invariably selected to suit the convenience of the honorary medical staff and the general convenience of the hospital See also:economy rather than to See also:save the patients and their friends long journeys in See also:search of medical aid . The best of the municipal systems too enables economy to be en-forced in the administration by a plan which provides a central See also:office in every See also:town where the number of vacant beds in each hospital is known, so that the See also:average of occupied beds in all the hospitals can be well maintained from an economical point of view . This speedy and ready inter-communication between all hospitals in a great city, which might perfectly well be secured under the voluntary system if the managers could only be brought into active co-operation, prevents delay in the See also:admission of urgent cases, promotes the See also:absence of See also:waste by keeping the average of beds occupied in each establishment high and See also:uniform, and has often proved a real gain to the poor by the diminution in cost to the patients and their friends, who under the best municipal systems can find a hospital within reasonable distance of their home in a large city wherever it may be placed . Another advantage of the municipal system should be that central control makes for economical administration .

Unfortunately a See also:

close study of this question tends to prove that municipal hospitals for the most See also:part have resulted in a dead monotony of relative inefficiency, often entailing great extravagance in buildings, and accompanied by much waste in many directions . Existing municipal hospital systems are attended by several See also:grave disadvantages . The administration shows a tendency to lag and grow sleepy and inert . The absence of competition, and the freedom from continuous publicity and criticism such as the voluntary hospitals enjoy, make for inefficiency and indifferent work . Rate-supported hospitals, as a rule, are administered by permanent officials who reside in houses usually situated on the hospital sites, and who are paid salaries which attract the younger men, who, once appointed, tend to continue in office for a long period of years . This fixture of See also:tenure is See also:apt to cause a decline in the general interest in the work of the municipal hospital, due mainly to the absence of a continuous criticism from outside, and so the average of efficiency, both in regard to treatment and other important matters, may become lower7-9'3 and See also:lower . Those who have habitually inspected great rate-supported hospitals must have met instances over and over again where a See also:gentleman who has held office for twenty or See also:thirty years has frankly stated that his income is fixed, that his habits have become crystallized, that he finds the work terribly monotonous, and yet, as he hopes ultimately to retire upon a See also:pension, he has See also:felt there was no course open to him but to continue in office, even though he may feel conscientiously that a See also:change would be good for the patients, for the hospital and for himself . Under the voluntary system evils of this See also:kind are seldom or never met with, nor have these latter establishments, within living memory, ever been so conducted as to exhibit the grave scandals which have marred the administration of rate-supported hospitals not only in Great Britain but in other parts of the world . We believe that the more thoroughly the advantages and disadvantages of rate-supported and voluntary hospitals for the care of the sick are weighed and considered, and the more accurate and full the knowledge which is added to the See also:judgment upon which a decision can be based, the more certain will it be that every capable See also:administrator will come to the conclusion that on the whole it is good for the sick and for the whole community that these establishments should, at any rate in Great Britain, be maintained upon the voluntary system . Of course it is essential to have rate-supported hospitals where cases of infectious disease and the poorest of the people who are dependent largely upon the poor-law for their See also:maintenance can be cared for . It is satisfactory to be able to state that of See also:late years the administration of both these types of rate-supported hospitals has greatly improved . The added importance now given all over the country to medical officers of health, and the disposition exhibited, both by See also:parliament and government departments, to make the position of these officers more important and valuable than ever before, have tended largely to improve the administrative efficiency of hospitals for infectious diseases .

No doubt the whole community would benefit if residents in every part of the country could be moved to take a See also:

personal interest in the infectious hospital in their immediate neighbourhood . Amongst the smaller of these establishments there has been so marked an inefficiency at times as to cause much avoidable suffering . The existence of such inefficiency casts a grave reflection upon the See also:local authorities and others who are responsible for the evils which undoubtedly exist in various places at the See also:present time . Unfortunately knowledge has not yet sufficiently spread to enable the public to overcome its fear and dread of infectious maladies . It is therefore very difficult to induce people to take an active interest in one of these hospitals, but we look forward to the time when, owing to the activity of the medical officers of health. who have immediate See also:charge of buildings of this kind, this difficulty may be overcome, when the avoidable dangers and risks and the appalling discomfort which a poor sufferer from a severe infectious disease in a rural See also:district may suddenly have to encounter under existing circumstances, would be rendered impossible . The poor-law infirmary in large cities, so far as the buildings and equipment are concerned, very often leaves little to desire . Poor-law infirmaries lack, however, the stimulus and the checks and advantages which impartial criticism continuously applied brings to a great voluntary hospital . Such disadvantages might be entirely removed if parliament would decide to throw open every poor-law infirmary for clinical purposes, and to have connected with each such establishment a responsible visiting medical staff, consisting of the best qualified men to be found in the community which each hospital serves . The old See also:prejudice against hospital treatment has disappeared, for the least intelligent members of the See also:population now understand that, when a See also:citizen is sick, there is no place so good as the wards of a well-administered hospital . Looking at the question of hospital provision in Great Britain, and indeed in all countries at the present time, it may be said, that there is everywhere See also:evidence of improvement and development upon the right lines, so that never before in the history of the world has the See also:lot of the sick, See also:man or woman been so relatively fortunate and safe as it is in the present day . Probably it is not too much to say that to-day hospitals occupy the most important position in the social economy of nations . See also:Classification of Hospitals.—Having dealt with hospitals as a whole it may be well very briefly to classify them in See also:groups, and explain as tersely as possible what they represent and how far it may be desirable to eliminate by consolidation or to increase by disintegration the number of special hospitals .

General Hospitals.—These establishments consist of two kinds, (a) clinical and (b) non-clinical, each of which, under the modern system, should include every department of medicine and See also:

surgery, and every appliance and means for the alleviation of suffering, the healing of wounds, the reduction of fractures, the removal of mal-formations and See also:foreign growths, the surgical restoration of damaged and diseased See also:organs and bones, and everything of every kind which experience and knowledge prove to be necessary to the rapid cure of disease . The clinical hospital means an institution to which a medical school is attached, where technical instruction is given by able and qualified teachers to medical students and others . A non-clinical hospital is one which is not attached to a medical school, and where no medical instruction is organized . Special Hospitals.—Up to about 184o the general hospital was, speaking generally, the only hospital in existence . Twenty years later, as the population increased and medical science became more and more active, some of the more ardent members of the medical profession, especially amongst the younger men, pressed continuously for opportunities to develop the methods of treatment in regard to special diseases for which neither accommodation nor appliances were at that time forthcoming in general hospitals . In a few cases, where the managers of the great general hospitals were men of See also:action and initiative special departments were introduced, and an See also:attempt was made to make them efficient . The conservative spirit which, on the whole, represents the British See also:character for the most part, resulted, however, in a steady resistance being offered by the older members of the medical staffs and existing committees to the See also:advocates of special departments . In the result, especially as such special departments as there were in connexion with general hospitals were too often starved for want of means and men for their development and improvement, the younger See also:spirits called their friends together and ° began to start special hospitals . To-day every really efficient clinical general hospital has within its walls special departments of almost every description, which have been made as efficient and up-to-date as See also:money and knowledge can make them . Unfortunately the causes already referred to led to the establishment of hundreds of the smaller special hospitals, many of which were started in unsuitable buildings, and some of which have ever since maintained a struggling existence . Others, on the contrary, through the See also:energy of their original promoters and the excellence of the work they have done, have obtained a position of authority and reputation which has had a very important bearing for good upon the development of medical science in the treatment of disease . If the world had to-day to organize the very best system of hospital accommodation which could be evolved, there is no doubt that few or none of the special hospitals would find any place in that system .

As matters stand, however, the special hospital has had to be accepted, and nothing which King Edward's Hospital Fund has done in London has met with greater popularity and professional approval than the labours which its See also:

council have undertaken in promoting the amalgamation of the smaller special hospitals of certain kinds, so as to secure the provision of one really efficient special hospital for each speciality . No doubt this policy of amalgamation will be steadily pursued, and in the course of years every great city will gradually reorganize its hospital methods so as to secure that, whether the patients are treated in a general hospital or in a special hospital, the average efficiency in every institution shall be as high and as good as possible . We will take now the special hospitals in detail . ' See also:Cancer Hospitals.—The See also:justification for efficient cancer hospitals must be found in the circumstance that most scientific men of experience believe that, if adequate resources were placed at the disposal of the medical profession, the origin of cancer might be discovered, and so the human See also:race would be freed from one of the most awful diseases which affect humanity . Pending such a See also:discovery the experience of the cancer department connected with the See also:Middlesex Hospital in London proves to demonstration that the provision of adequate and special accommodation for the exclusive treatment of cases of cancer is not only desirable but necessary on humanitarian grounds alone . Hospitals for See also:Consumption.—For many years it was held that this See also:group of hospitals was not a necessity, and the patients were treated in the ordinary medical wards of the general hospitals . Since the contagious character of See also:tuberculosis became known, and improved methods of treatment have been developed, every one agrees that this type of special hospital is desirable, though it is believed by the more advanced school of scientists that before long it may be happily rendered obsolete owing to the discovery of methods of treatment which will stay the disease at its commencement and restore the patient to health . See also:Children's Hospitals.—These hospitals were very much opposed at the outset . There can be no doubt that the children's ward or wards in a big voluntary hospital is a most valuable asset to the managers, so long as the children are treated in separate wards; There is no reason of course why a hospital should confine its work to the treatment of children, exclusively . Still this special hospital is popular with the public; it has led to many discoveries and developments in the treatment of children's diseases; on the whole the administration of these establishments has been good ; and we believe they will continue to flourish, however many children's wards may be provided in general hospitals . Children's hospitals with country branches for the treatment of chronic ailments, such as See also:hip disease, are a valuable addition to the relief of suffering in cities . Cottage Hospitals.—These hospitals, established originally in 1859 by Mr See also:Albert Napper at Cranleigh, See also:Surrey, have fulfilled a most useful See also:function .

Many of them are very efficient both in regard to equipment and treatment . They have become essential to the well-being and adequate medical care of rural populations, as they attract to the country some of the best members of the profession, who are able, with the aid of the cottage hospital, to keep themselves efficient and up-to-date, so that all classes of the community are benefited in this way by this type of hospital . See also:

Ear, See also:Throat and See also:Nose Hospitals.—The history of this type of hospital bears out in every particular the reason we have given above for the establishment of special hospitals in the first instance . There can be no doubt that the best conducted throat hospitals have been beneficial to the poorer inhabitants of great cities, See also:Fever Hospitals.—Incidentally we have dealt with these institutions, which are usually supported out of the rates and administered by the medical officers of health, who are paid by the See also:county or municipal authorities . Maternity and Lying-in Hospitals.—This is one of the See also:oldest types of special hospitals, and has done a great See also:deal of good in its time . Owing to modern methods of treatment and hygienic developments the maternity hospital never occu pied a stronger position than it does to-day . See also:Mental Hospitals.—In Great Britain the insane are provided for in asylums (see See also:INSANITY, ad fin.), though such establishments, if properly conducted, are essentially hospitals . Scientific and public See also:opinion tend towards the establishment of mental hospitals to which all acute cases of mental disease should be first relegated for treatment and diagnosis before they are consigned to a permanent lunatic hospital . Too little See also:attention on an organized plan has been given to the continuous study of mental disease in its clinical and pathological aspects . It is probable, therefore, that the See also:advent of the mental hospital may See also:lead to important developments in treatment in many ways . Ophthalmic Hospitals.—Of all special hospitals this is one which would probably be the least necessary, providing general hospitals everywhere were properly equipped and organized . No special hospital has probably been so abused in the material sense by the See also:free relief of patients who could well afford to pay for their treatment at the ophthalmic hospital .

Several of the existing ophthalmic hospitals have entailed an enormous See also:

expenditure, and their modern equipment is wonderfully efficient . Orthopaedic Hospitals.—It is very doubtful whether this type oj hospital is really desirable or necessary . Its necessity may be advocated on the ground that orthopaedic cases may require See also:pro-longed treatment, and that the pressure upon the beds of general hospitals by acute cases is nowadays so great as to render the orthopaedic hospital more necessary than ever before . See also:Paralysis and Epileptic Hospitals.—Seeing that the percentage of those who are at present attacked by paralysis and See also:nervous disease shows a continued tendency to increase under modern conditions of life in large cities, hospitals of this type are necessary, and London at any rate, like most foreign towns of importance, possesses, at present, far too little accommodation for this class of case . Skin and Phota-Therapy.—Up to the end of the r9th century hospitals for diseases of the skin were a See also:constant cause of See also:scandal and criticism . The introduction of modern methods of treatment by See also:light and See also:electricity, including photo-therapy, has given an importance to this department and treatment which it did not previously possess . We are of opinion that, on the whole, it is better and more economical to treat these cases in properly equipped departments of general hospitals than in separate institutions . Women's Hospitals.—These hospitals are not absolutely necessary, but considering their popularity with the women themselves, and that several of them have done excellent work, remembering too that women constitute the See also:majority of the population, there seems to be some reason for their continuance.can circulate freely underneath . The See also: