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bine an imposing appearance with great economy in construction. It has the especial recommendation of being susceptible of gradual and indefinite extension, admitting of a commencement involving little outlay, yet complete as far as it goes. Mr. Ropes established his claim to the favorable opinion of the Committee by internal arrangements admirably disposed, and a distribution of parts, showing much judgment and artistic taste.
Among the plans which were especial favorites for their beauty of design, excellent disposition, and general adaptation, vere those of Mr. Boyden, who has already gained many laurels by his public buildings in various parts of the Commonwealth. He was aided in the distribution of the apartments by Dr. John Green, of this city, whose professional familiarity with the hospitals of Europe materially contributed to the completeness of the work. The arrangement of the wards is on the parallel pavilion plan, carried out in the celebrated model Hospital Lareboissiere, in Paris. It combines economy with that most important feature never to be disregarded in edifices, likely to endure through successive generations or centuries, of being exceedingly beautiful in its external elevation. We reluctantly came to the conclusion that the estimated cost, one hundred and twenty-eight thousand dollars, for the central building and two pavilions accommodating two hundred patients, was beyond the limit of prudence in times like the present, and that the arrangement was not so well suited for our purpose of a general hospital as that of Mr. Bryant. The Committee showed their approbation of this elegant design, by a vote of fifty dollars as a gratuity, the plans to be left in the possession of the City.
We would also mention with especial praise a set of designs transmitted from Paris, by the son of one of our valued associates in the government, who has made civil architecture a study, and paid particular attention to this branch of his art. They arrived too late to be admitted to competition for the prize, but we hope to secure them for the use of the committee who shall be engaged in perfecting the final arrangements. The plan is mainly that of the Beaujon, one of the most highly esteemed among the hospitals of Paris.
Other designs, and especially those of Mr. Rand, Mr. Fehmer, and of Woodcock & Meecham, the latter of whom, two years ago, gained, besides the premium offered, much credit for their accepted plan of the garden, now in successful prosecution and daily revealing new beauties, we have endeavored to secure for the consideration of the City Council. Each of these lias peculiar merits of its own, indeed not one of all that were presented but might perhaps have taken the premium offered had it been adapted to our particular purpose, or the tribunal been differently composed, for with all our endeavors to qualify ourselves for the task, and our aim to be impartial and conscientious, we feel all due diffidence of our ability to judge of their several claims to preference.
In determining the general arrangement of the different apartments for the proposed institution, it will be well to remember the diseases and classes of patients which we must provide for, but which are excluded from the Massachusetts. Many of these have been already enumerated. Malignant diseases, whether contagious or infectious, and especially when they come in the epidemic form in seasons of pestilence, must be isolated. Measles, varioloid, scarlatina, many cutaneous complaints, besides consumption, and child-bed fevers, require also separate treatment. The sexes must have assigned to them distinct portions of the buildings, and medical and surgical patients are not usually mingled in the same wards. Where there are surgical cases, erysipelas is ever on the lurk, and often spreads its wildfire desolation in defiance of the utmost precaution. The only safeguard is in a multiplicity of rooms, and these open to the most searching ventilation, so that one when infected may be vacated and purified while the others are in use, without driving patients away from the hospital. Our exposure at all times to the sudden and insidious approaches of epidemic disease, and to the consequences of war counsel, for a wealthy and sensible community like that of Boston, the provision in advance of hospital accommodation far beyond any exigencies actually experienced.
One marked advantage we have over most European cities, and
many of our own, is our abundance of pure water. The benefits of this blessing are nowhere more appreciated than in hospital practice. One of the eminent physicians who compose our consulting board, expressed himself on this subject to the Committee with great earnestness and eloquence, recommending that baths of the most approved description, vapor, salt, and medicated, and of every other variety, should be liberally introduced into the arrangement, not simply for the sake of cleanliness but as a means of cure.
This feature has not been so prominently embraced in the designs offered as we could have wished, but should be borne in mind by those to whom may be intrusted the erection of the hospital. We would also suggest the policy of open fireplaces as an important part of all approved systems of ventilation, and that the windows, either with French sashes or sliding into the wall, should open as near as possible to the ceilings of the wards. We would also recommend that the sewerage of the house should be carried as directly as possible outside the walls, no drains being permitted to run under the buildings. It would seem advisable that the ground should be raised sufficiently above the grade of the street, in terraces or slopes about the buildings, to admit of the present level of the field being that of the cellar floors. Should these floors be properly paved with brick, to exclude all exhalations from beneath, and the surface of the ground generally be covered with garden-earth and vegetation, the position, though artificial, will prove very nearly as salubrious as upland.
After the commencement of the work we shall have abundant time, during its progress, to organize the details of its management and control. But as, in the early part of this report, we have stated the annual expenditures of the Massachusetts Hospital, which have always been upon a scale of great liberality, we would remove the natural but still erroneous impression that these must necessarily serve as a standard for our own institution. The noble endowments, the class of patients, and the character of the cases treated, have justified very different rules for their government from what good policy would dictate for ours.
The inmates of the public institutions, charitable and reformatory, averaging about twelve hundred and fifty souls are maintained at a cost of about two dollars a week, the aggregate disbursements being about one hundred and seventy thousand dollars, from which there is to be deducted about thirty thousand for income. The nourishment of the sick will be more costly, but still will be in a measure graduated by the degree of comfort to which they may have been previously accustomed.
Already, physicians of standing in their profession have volunteered their services as regular attendants, and the generous readiness evinced at all times by the faculty to give the poor the gratuitous benefit of their experience, encourages the hope that a public charity like this will secure the best medical and surgical talent. Apart from the benevolent impulses to which they have ever thus promptly responded, clinical experience is the path to eminence as well as to lucrative employment, and this, if not their incentive, will prove their reward. The illustrious example of Florence Nightingale has been emulated in all countries by noble women wise enough to know that employment in contributing to the welfare of others, and especially of the poor and needy, is happiness here and hereafter, but who consecrate their lives to pious duties, actuated by motives more generous than any such considerations. Sisters of Charity, Roman and Protestant, in foreign lands as in our own country, are discouraged by no fatigues, discomforts, or danger from regular attendance at the pillow of disease. That our community will produce many eager to devote their time to these duties, past experience forbids us to doubt. Educated in the best schools, among so many sources of knowledge, they will learn to rival that most excellent of nurses, Rebecca Taylor, whose well-merited praise from one who lives in the hearts of all of us, still echoes on the public ear. The accomplishments acquired in the hospital will carry comfort to the sick-bed, in the dwellings of the poor as also in the abodes of affluence. We would not grudge to such invaluable service its usual recompense. It should merely be so ordered that neither rich nor poor should be excluded from it.
We feel assured that no large annual appropriations will be required for the support of the institution when completed. But should the average charge of each patient equal or even exceed that in the existing hospital, when we remember the amount of suffering that will be relieved, the usefulness we shall restore to society, and the precious lives to be preserved from an untimely doom, all must feel that the outlay will be more than reimbursed, and that an edifice so sacred and so much in need should be raised at the earliest moment prudence will permit.
In the early moments of dismay and discouragement, occasioned by our national calamity, we naturally directed every effort to military preparation. Our expenses were economized, our resources husbanded, and all public works of magnitude not already commenced were postponed to a more convenient season. But the energy displayed by the vast preponderence of our people who continue faithful to constitutional obligations and legally constituted authority, is creating everywhere a feeling of security, a confidence in the eventual successful overthrow of the rebellion. The acknowledged disparity of forces in the field, our numerous reserve and ample resources, and the growing sense of the South that it has misapprehended northern sentiment and northern designs, lead us to hope for a speedy termination of this unnatural struggle--a restoration of that good fellowship and affection between the sections planted by Washington on Dorchester Heights, and by Greene at Eutaw, which the insane ambition of party leaders will not be able again very soon to disturb.
If this hope have, as we firmly believe, reason for its base, we may well reconsider our first hesitation. If the hospital be an actual necessity, its erection is merely a question of time, and it can be constructed now with much greater economy than in a season of usual prosperity, Materials are at least one fifth cheaper than this year twelve month, and while we have under arms ready for service five thousand men not called for, because not supposed to be needed, other thousands are out of employment and in want, from the interruption of all industrial pursuits