being devoted to it. In Dublin, without amalgamation of hospitals, this could not be afforded. Rokitansky devotes his whole time to the dead-house of the Vienna hospital, with what results I need not say. The opening of resident offices gratuitously, or even in some with remuneration, to the most deserving pupils in the matters of knowledge, propriety, and industry, cannot but afford a salutary stimulus to exertion. In some American hospitals every third-years student is obliged to reside, and act as dresser for at least one week under direction of the house surgeon; and if a somewhat similar plan were adopted with us the production of good practical surgeons would be greatly fostered. If the officers of the larger hospitals were to give notice of operations or interesting cases and autopsies in the medical journals, great advantage to the junior practitioners or strangers would accrue.

For want of space the important subject of hospital hygiene cannot be dwelt on here, but it must be acknowledged that public opinion, stimulated by the statement and addresses of many famous medical men, is gradually tending to the belief that hospitals are injudicious and old-fashioned institutions, and that a well-organised system of home treatment is more calculated to aid the sick and at a lesser expense. Hospitals built twenty years ago are termed dangerous for treating surgical accidents, and the demolition of those in which pyæmia has arisen is called for. It is therefore all-important for the interests of humanity, as well as for the present system of medical education, that this problem should be set at rest by the collection of reliable statistics and other data on the subject; and if the government cannot be induced to establish such an inquiry, the profession itself should take the initiative. All hospitals would gladly give facilities, and the surplus funds of the British Medical Association would be well spent in bearing the expenses of at least some dozen

commissioners, who would conduct the inquiry in an exhaustive and disinterested way. Besides the definite question of hygienic construction, the site, class of cases, and methods of selecting them and recording their character and results, should be considered, so that the inquiry would be both difficult and prolonged. It is a positive truth that the poor in hospital have better advice than their wealthy brethren, for they are attended by the most eminent men assiduously, as any want of skill or care would be detected by colleagues or pupils. The main impulse given in this city to improved hospital ventilation was the exposure in 1809, by Carmichael, of the mortality and delicacy of the children in the House of Industry, St. Thomas's and Bethesda schools, owing to want of pure air. The council of the London College of Surgeons influenced the matter strongly by refusing to recognise hospitals which did not give 1,000 cubic feet of space to every patient.

The hospitals of London have been endowed with a munificence worthy of the citizens of that greatest of capitals. The most ancient Bartholomew's, has 650 beds open for those who need them, without recommendation. In the new wards of another, Guy's, each patient has 2,000 cubic feet, the greatest space allowed in any British hospital. The richest of them, St. Thomas's, is about to be rebuilt opposite to the Houses of Parliament at a cost of £360,000. Mr. Morley, at one time a medical student, but afterwards a hotel proprietor, bequeathed £150,000 to St. George's hospital, besides many other sums to medical charities. Their great size renders it difficult or impossible to close them if contagion spreads within them. The practice of paying the clinical visit at twelve or one in the day is injurious, by encouraging the lie-a-bed pupils; and as private engagements will encroach on such hours, the teachers must hurry through the wards. The Irish and Continental hour of nine A.M. is therefore preferable. Physiological

principles also teach that patients are then best able to bear pupils' examinations and operations. The officers are usually paid only by pupils' fees. In the Paris and most other continental hospitals, a small salary, about £60 a-year, is given to each attendant. The great fault of their elective system is slowness of promotion; thus, Abernethy was kept in the subordinate position of assistant-surgeon for twenty-eight years. Many of them have now a rule by which the surgeons must retire on the attainment of sixty-five years; they then should become consulting surgeons, with a proper emolument as reward for past services. The generous nature of Carmichael prompted him to make way for a deserving junior in the Richmond Hospital when he was but fiftyseven years of age; and shortly after, on leaving the President's chair at the College of Surgeons for the third time, to encourage rising practitioners he confined his practice to house patients, or consultations outside with other practitioners.

The hospitals and dispensaries of London are so largely used by persons whose circumstances demand that they should pay for medical aid, that it has been proposed to make them provident or self-supporting institutions for all who could not give clear evidence of pauperism. By such perversion of these charities much wrong is done to the general practitioner. It does not. appear that in Dublin similar frauds exist, for there, indeed, the proportion of poor inhabitants is so great, that the hospitals can be readily filled with deserving objects of charity. The Richmond, Whitworth, and Hardwicke hospitals are supported solely by government, and directed by a board which it nominates. The hospitals which are partly supported out of public funds are, Dr. Stevens', the Meath, the Lock, Cork-street Fever, the Rotundo and Coombe Lying-in, St. Mark's Ophthalmic, and the Incurables hospitals. All these are superintended by a board of twelve members (of whom about

one-third are medical) appointed by the Lord Lieutenant, to whom they annually report on the duties of officers and the general management of the institutions. The annual grant amounts, for the year ending the 31st of March, 1865 (no later accounts have been published), to £15,722 15s. 9d. distributed as follows-Lock, £2,600; Stevens', £1,300; Meath, £600; Cork-street, £2,500; Richmond, &c., £7,472 15s. 9d.; Rotundo, £700; Coombe, £200; Incurables, £250; St. Mark's, £100. The parliamentary committee reported that it was just these hospitals should be supported, as the poor of Dublin were deprived of hospital endowments by the subversion of monasteries, at the Reformation, and such funds were restored elsewhere-Bartholomew's and St. Thomas's in London, for instance. The consolidation of the hospitals, and the distribution of the grant among all, have often been urged; two are so ill-built that they should be remodelled, and another should be Christened (more than a change of name being implied by that word).

A few particulars about each of the Dublin hospitals may be noted, and we take them in alphabetical order. Adelaide-100 beds, 2 physicians, 4 surgeons; voluntary contributions. Patients exclusively Protestant. The only other hospital, as far as we are aware, in which religion is the test for admission is the Augsburg hospital, which was endowed for the benefit of Catholics and Protestants; but dissension arising, it has been halved between them, separate administrations and consequent expense being involved.

City of Dublin-104 beds (instead of 50, as stated in Oppert's Treatise on Hospitals), 2 physicians, 5 surgeons. Established in 1832 by professors of the College of Surgeons; voluntary contributions, and £300 yearly from Corporation.

Dr. Stevens' hospital-250 beds, 2 physicians, 3 surgeons; endowed in 1720 by Dr. Stevens, and £1,300

yearly from government grant. The only hospital in Dublin which has a school directly attached. The class was thereby increased, for while the pupils in 1855 and 1856 were 11 and 23 respectively, they numbered 61 in 1857.

Jervis-street hospital-60 beds, 2 physicians, 7 surgeons; the oldest in the city (1721), now directed by Sisters of Mercy; £200 grant from Corporation.

Mater Misericordiæ-100 beds, 2 physicians, 4 surgeons; built in 1861; it comprises every hygienic requisite; £300 grant from Corporation and subscriptions. Directed by Sisters of Mercy.

Meath hospital-120 beds, 2 physicians, 6 surgeons (1753); county grant, £600 from hospitals grant, £300 yearly from Corporation and contributions. Famed as clinical school.

Mercer's-66 beds, 2 physicians, 4 surgeons (1734). Endowment from Corporation of £300, and contributions. If funds permitted, reconstruction is much called for. . Richmond Surgical, Whitworth Medical, and Hardwicke fever hospitals-312 beds, 4 physicians, 4 surgeons, the number having been reduced from 5 in 1864 without sufficient reason; wholly supported by government. The museum contains 4,000 objects of extreme value. The Richmond was most ill-constructed, but new wards were opened in February, 1866. The hospitals receive about £7,472 from government yearly.

St. Vincent's-100 beds, 4 clinical teachers (1834), Directed by Sisters of Charity; £300 from Corporation, and contributions. Possesses a sanatorium of 20 beds at Stillorgan.

Sir P. Dun's-100 beds, 3 physicians, 3 surgeons. Endowed by Sir P. Dun, M.D. Directed by School of Physic.

The Coombe receives £520, the Incurables £200, and St. Mark's Ophthalmic £100, from city funds, making a total of £2,520 to the hospitals.