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We need not go down the noble list of such Christian

hospitals as St. Basil’s, given with surpassing interest ofdetail by Paccinotti. More to our purpose is it to pointout how the service vouchsafed by early Christianity toMedicine was reciprocated by that of the later Medi-cine to Christianity, and how both institutions—theMedical and the Christian—have reacted upon eachotlier for good. For the second time in its historythe healing art broke away from its religious connexion,now become unnecessary; and having regained the soundtraditions of Hippocrates, it pursued its independent career,not antagonistic to Christianity, but as a humanitarianforce in alliance with it. The Church, by the admission ofits best apologists, had before the Renaissance become

corrupb and (unable to continue in its degenerate course)had to take a fresh departure. By this time Medicine, withthe apparatus of the hospital system in full working order,was rapidly putting to flight the superstitions, the belief incharms, and the spiritual exorcism which the Church,thanks to it, was outgrowing in turn. Each having dis-encumbered itself of an outworn superfoetation, they joinagain, on a higher plane, to continue with combinedforces their fight for the elevation of humanity. It is thisalliance that is celebrated with yearly recurring solemnityon "Hospital Sunday," an institution which typifies allthat is best among the dominant forces of civilisation.Church and Hospital, the two can never ignore each otherwithout mutual loss. If " the great physician is a greatartist," seeking, while rehabilitating the individual, to

regenerate mankind, his most natural and helpful ally canbe no other than the apostle of that faith whose function itis to remind him that his ideal is the " image of God."

SANITARY DEFECTS OF THE HOSPITAL

LA PITIÉ AT PARIS.(FROM OUR SPECIAL CORRESPONDENT.)

FROM time to time complaints have reached us concerningthe insanitary condition of the celebrated Parisian hospitalLa Pitié. This institution, founded in 1613, has neverthelesshad a distinguished history in the records of modern progress.Here was established one of the earliest and best schoolsfor the training of hospital nurses, and many of the mostdistinguished physicians and surgeons of France, andindeed of several other countries, owe their success tothe excellent clinical school of La Pitie. Yet this hos-pital, like many other hoary institutions, is in a very

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insanitary condition. Whatever may be taught here,it is evident that the lessons given in hygiene are

theoretical rather than practical. The building hadformerly been a poor asylum, then a home for foundlings,and in 1809 it became an annex of the Hotel Dieu. Newwings have been at various times added to the originalstructure, and some old portions were pulled down to givemore yard space, and thus secure more light, air, and ven-tilation. Also the present director of the hospital is to bewarmly congratulated for having succeeded in substitutingsyphoned-trapped and well-flushed closets for the abomina-tions which formerly infected all the wards.Generally speaking, in seeking for defects in sanitation,

it is necessary to look to the less frequented parts of ahospital. At La Pitie it is j ust the reverse. Some of theworst features of the building are those which are mostevident, and are seen by the greatest number of people. Thusthe office at the entrance of the hospital is a wretched littlechamber where three clerks are crowded together, surroundedby dusty shelves loaded with musty papers. Such portions ofthe wall as remain visible are dirty, and have not been white-washed for the last three years. A little window opens intoone of the receiving rooms for out-patients, and from thisroom, where persons suffering from so many different maladiesdaily congregate together, germs may pass through thewindow to sojourn among the clerks and rest in the dust

and dirt on the rafters and amid the books, papers, reports,and accounts. In the out-patient receiving room there is alibrary, whence books are taken to lend to patients,and here the tile pavement of the floor is worn out, andsand and dirt have filled the crevices. In the morningcrowds of people come together in this most insanitaryroom, and wait to see the physician. During the rest ofthe day any sick person brought to the hospital is depositedin this room and left there on a stretcher till all theformalities have been accomplished and a bed allotted tothe patient in one of the wards. Thus this room is con-stantly invaded by the suffering sick poor, and thoughinfectious cases are not admitted into the hospital, stillthey sometimes are brought here by mistake or throughignorance of the true natare of the malady, and have toremain in this most unsuitable room till they can be sent toa hospital where there are infectious fever wards. We needhardly point out that a room where crowds of sick peoplecome and wait every day should be kept scrupulouslyclean, should be well lit and ventilated, and there shouldbe no corners, ledges, cracks, or crevices where dust andgerms may accumulate.

Close by there is another room for the surgical patients.Down the centre of the ceiling of this room there is a hugerafter borne up by a wooden pillar, which is not evenpainted, so that the pores of the wood can readily absorbthe exhalations of the patients. At angles with this largerafter there are fourteen smaller rafters. The ceilingbetween these rafters is deeply stained with dirt. Angles,corners, and sombre recesses abound on all sides. In onecorner of the room there is a bed, not for the patients, butfor the night porter, who sleeps here, near to the door,and is ready to turn out at any moment of the night toadmit cases of accidents &c. Thus the waiting-room, wherescores of surgical patients arrive every day, is also a bed.room. The light and ventilation are most defective. Allthe light admitted is through one small window. Nor havethe rooms the advantage of the ventilation an open fireplacecan give, but is warmed in winter by a porcelain stove,which largely contributes to vitiate the atmosphere. Thefurniture also is not in any way antiseptic; but there are,on the contrary, straw-bottomed chairs that readily accumu-late and retain the dust. This part of the building is pro-bably some centuries old, and is in every respect’absolutelyunsuitable to the purpose for which it is employed. If therebe any truth at all in the germ theory, the attendance ofso many patients in rooms so badly lit, and so full of darkcorners, must be injurious and dangerous. It would befar better to erect a simple tent in the yard than toallow the patients to wait under the old rafters thatbear up the ceiling of the surgical receiving room.

These offices and receiving rooms are immediately tothe left of the main entrance to the hospital. On theright a large amount of valuable space is occupied by thehuge and ugly church of the hospital. This church canseat 600 persons. Formerly people from outside the hospitalwere allowed to attend service here. Now this is no longerthe custom, nor is it in any way necessary. Thereare plenty of other churches in the neighbourhood wherethe congregations are anything but numerous. At theChurch of La Pitie Hospital we were assured that theaverage congregation amounted to only fifteen persons. Evenif it were twice or three times that number, there wouldbe no need to preserve a building capable of seating sixhundred persons. As it is, a great portion of the church isconverted into a sort of lumber-room for flower-pots, smalltrees, that are wheeled in during the winter months, andvarious other objects. When the other day the censuswas taken at the hospital, it was found that there were, in-cluding attendants, nurses, children &o , 951 persons sleep-ing on the premises. It is urged that if out of such apopulation the church fails to attract a congregation ofmore than a score of persons, the time has come when, inthe face of the present urgent need of space, a small chapelshould be built in its stead. There would then be amplespace, and this conveniently situated just at the entranceof the hospital, for the construction of handsome and modelreceiving, waiting, and consulting-rooms for medical andsurgical patients, offices for the administration &c.With regard to the wards of this hospital there is nothing

very special to be said. They have windows on both sides,therefore good light and through draughts might be estab.lished, if the authorities could only be pursuaded to openthe windows facing each other. Some of the wards are of

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Receiving and waiting 1’0O.1l for surgical cises at 1’Hopital de la Pitie, Pal-i,,.

The attic occupied by the male nurses at 1’Hupita.l de la Piti6, Paris.

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more recent construction, and are loftier and brighter ; butthere are no special means of ventilation, and it is wellknown how little trust can be placed on the mere openingof windows. The lack of uniformity in the management ofthese wards is very remarkable. In some wards the bedsare surrounded by the traditional white curtains, so dear tothe Frenchwoman’s heart. These curtains are changed andwashed every four months. In other wards the surgeonor physician in charge may be under the influence ofmore modern notions, and has ordered all the curtains tobe removed. In the same manner the treatment of thepatients varies. In one ward the greatest precautions aretaken, while in another the most extraordinary neglect pre-vails. Thus in a ward I noticed a patient suffering fromenteric fever, and asked the nurse what was done withthe dejections of this patient. They were, it appears,simply thrown down the drain. Precautions were taken,the dejections were disinfected before they were allowed toreach the public sewer when an epidemic prevailed; butwhen there was no epidemic no precautions were taken !In other words, the stable door is only closed after thehorse has been stolen.The wards on the first floor are lofty; those on the second

floor are fairly well disposed, but those on the third floorare very low, so low and tunnel-shaped that they recall theaspect between decks on board an emigrant ship. It mighthave been thought that the less serious cases would be putin the wards that are not so well disposed. This is not,however, the case; the patients are allotted to the differentwards without taking into consideration the hygienic con-dition of these wards. Some of the wards also, and this isa grave defect, have laboratories annexed, where the exa-mination with the microscope of pathological specimensbrought from the post-mortem room is done.The bath-rooms also are very badly disposed-very small,

crowded, and some of them placed under a sick ward,where they must help to maintain a condition of dampnessprejudicial to the health of the patients. The place fordouches &c. is not large enough for the successful applica-tion of hydropathic treatment; the want of air, light, andspace is altogether deplorable when we consider what arethe requirements of so large a hospital.The post-mortem room, the dissecting-room, and the dead-

house are situated side by side in a sort of cellar. Thisbasement is dark, damp, sinister-in every respect unsuitedfor the purpose. Here also there are any number of rafters.In the dead-room, over fifteen bodies, I counted thirtyrafters, which were too high up to be cleaned. It mustbe prejudicial to the health for students and professors tomeet constantly in such places; but they are not the onlysufferers. The accommodation afforded to the male andfemale nurses is a perfect scandal. It is vary much to thecredit of the professors at this hospital that they havesucceeded in training nurses when these postulants receivesuch poor treatment. One of the rooms occupied by thewomen nurses is under a sloping roof. There is one windowabout a yard square, which gives but little light, andthis not only because it is so small, but because thereis opposite and close to it the high wall of a house.In the nurses’ room there was no cupboard for theirclothes, there is only one small straw chair for eachperson, then by the side of some of the beds there is nomat, so that the nurses on rising have to step on

the bare floor. Beyond this room there is yet another orinner room which has no window whatever, and itslight is only the borrowed light from the outer room. It isnever light enough in this inner room to read even in thi-brightest summer day, yet in this dark hole two femalenurses have to sleep every night. It was justly observed byseveral persons at the hospital that prisoners in a State gaolhave much better accommodation than the free, trained,professional nurses at the Hopital de la Pitié. The menare for the most part huddled together in an attic, wherethe roof is so low that the beds can only be reached bystooping, and a man cannot stand upright except in thevery centre of the dormitory. There are rickety smalliron bedsteads, with bent legs, and altogether insufficientbedding. There is no furniture whatever, no lockers, nocupboards, no means of washing. The men have to dresshere, then go down into the sick wards, and wash inthe lavatories provided for the patients. There also theymay keep achange of clothes or of linen. Thus they haveno privacy. They are compelled to wash in common withthe patients, and to sleep in a garret where there is no ’,

provision whatever made for their comfort. The garretbeing immediately under the roof, its occupants are exposedto the extremes of heat and cold. The accompanying sketchmay give some idea of the great discomfort which themale nurses at La Pitie Hospital have to endure. Belowthem are three floors of wards full of patients, so that, whensleeping, the nurses must breathe some of the exhalationsfrom these patients, which percolate upwards through thefloors and ceilings.This is assuredly a very serious grievance, which affects

the general interests of the public as well as the individualswho are thus so badly treated. It must be felt thatnurses, whether male or female, deserve every respect andconsideration. Everything should be done to give thema due sense of the dignity and responsibility of theirwork. They should therefore be treated with respect,and not left to herd in unfurnished garrets or in darkrecesses where there are no windows, and where theirhealth must be injured. Such treatment of hospital nursesis a remnant of former ignorant prejudices, which are

altogether unworthy of so civilised a city as that of Paris.The members of the Municipal Council cannot be aware ofthe state of affairs that prevails at the Hopital de ]a Pitie,otherwise this energetic and progressive body would havetaken the matter in hand long ago. Perhaps, however, afterthe publicity which we trust will now be given to these factsthis matter will not remain in abeyance much longer. The

Municipality and the Administration of Public Assistancewill take measures to reconstruct some portion of the hos-pital, so that the nurses may have proper sleeping rooms,and the hospital administration suitable offices and receivingrooms for the patients. The numerous other improvementsnecessary could be accomplished at the same time, so thatthe hospital may be placed on a level with the requirementsof modern sanitary science.

THE PROPOSED ALBERT UNIVERSITY OFLONDON.

THE proposals of the Royal College of Physicians ofLondon and of the Royal College of Surgeons of Englandfor powers to grant an M.D. degree, and the scheme of theUniversity of London to adapt itself to become in part aTeaching University for London, have failed, and the PrivyCouncil has asked the authorities of University and King’sColleges to present their cae as the third alternative forthe promotion of a Teaching University in London. Weunderstand that the counsel who are instructed in supportof or against this proposition must be ready by the22nd inst. There is a suggestion of pleading for delay onbehalf of the Royal Colleges and of some of the medicalschools ; but it seems doubtful to us, as the question is nowof so many years’ standing, whether this is a wiseprocedure, and whether it will be granted by the PrivyCouncil. We append a précis of the principal clausesrelating to the Medical Faculty in the proposed DraftCharter. The complete draft was published by us onAug. 6th, 1887. It is of grave importance to theLondon medical schools that they should recognise thatthere is no provision for their direct representation onthis Council, and that they should take every means tosecure a fair share in the government of the University.University and King’s Colleges have other interests to pro-tect on the part of arts and science, but from the medicalside there is no reason why they should have anything buta proportional representation in the control of a new

University for London. It would be regrettable if a want oforganisation on the part of the London medical schoolsshould place them at a disadvantage before the PrivyCouncil.EXTItACTS FROVI DRAFT, ADOPTED BY THE COUNCILS OF UNIVERSITYCOLLEGE, LONDON, AND KING’S COLLEGE, LONDON, FOR THE CON-STITUTION OF PROPOSED NEW UNIVERSITY.

THE INSERTION OF THE PASSAGES IN SQUARE BRACKETS [ ] ISCOBTIVGEB1 UPON THE ROYAL COLLEGE OF PHYSICIANS OF LONDONAND ROYAL COLLEGE OF SURGEONS OF ENGLAND BEING ASSOCL1TEDWITH THE UNIVERSITY.

Foundation of the .1lùert 1’adt‘erst.Thpre sl111l1 be and there is hereby constituted and founded a Univer-

sity, in and for London, with the name of the Albert University ofLondon.