Page:The New International Encyclopædia 1st ed. v. 10.djvu/287

* HOSPITAL. 247 HOSPITAL. Efforts were set on foot as early as 1700 it establish a liospital in Philadelphia. In 17.30-31 the city almshouse was founded, and did medical work; but it was not until 1750-51 that the Pennsylvania Hospital lirst had its actual birth. Josliua Crosby was the first president of the board of managers, and Benjamin Franklin the first clerk. The New York liospital was the second hospital of importance. Its cliarter was granted in 1771. From these earl}' beginnings there has now grown up in the United States a veritable forest of hospitals. Every city, town, and village has its duly appointed hospitals, and the hospitals of the United States are now ac- knowledged the most handsomely and thoroughly equipped in the world; they serve as models for Eurojjcan archifeets. In most of the larger cities of the United States there are two or more hospitals that are under the control of the citj' government, and used exclusively for the city poor. Such are the Johns Hopkins Hospital, in Baltimore; the Phil- adelphia Hospital, in Philadelphia; Bellevue, City, Fordham, Harlem, and Gouverneur hospi- tals in New York; Massachusetts General, ami Boston City, in Boston; Cook County Hospital, in Chicago; etc. In addition to these municipal hospitals there are numerous institutions founded by private gift and by sectarian societies, such as the New Y'ork Hospital, Roosevelt, Presby- terian, Saint Luke's, German, French, Mount Sinai, Saint Vincent's, Saint Mark's hospitals, etc., etc., in New Y'ork, and hundreds of others in other cities. Further, there are numberless special hospitals for the treatment of separate diseases: hospitals for diseases of the eye, the ear, the nose, the throat; cancer hospitals; hos- pitals for diseases of women; for diseases of the skin, and for all the various specialties. The details of hospital management cannot be entered into here. The medical side of the work is usiially fashioned on well-established lines. In the larger hospitals the patients are imme- diately cared for by the nurses (nurses are paid a small salary unless they are sisters of some religious denomination) ; these are under the orders, so far as the treatment is concerned, of the internes, or young graduates in medicine who have gained this privilege by competitive examinations, and who serve in graded positions for periods of time of from one to three years. These generally reside in the hospital, receive no salary, save their living, and are constantly in attendance. The externes, on the other hand, are under the supervision of the attending or visiting phyxicinni}, who are practitioners in the city, chosen by the governing boards of the hospitals for their ability or for other reasons. These visit the hospitals at specified times, and outline the plans of treatment for the patients. Their time and services are usually given gratis, always so in the municipal hospitals. Many hospitals have consulting physicians who may be called in to diagnose rare conditions, but such appointments are usually rewards for work done in the other grades, and carry with them honor and position in the estimation of the laity. In the smaller hospitals this system may be much modified to meet the circumstances, but the main fentiires are preserved. Chiefly within the past century a sy.stem of hospitals specially designed for the care and treatment of the insane has been established all over the world. In this country these institutions are supported by the several States. The State of New York has sixteen such hospitals, each acconunodating from a few hundred to a few- thousand patients. The physicians who serve in these hospitals are specialists in mental dis- ea.ses, and receive salaries which vary with the length of service. Very recently acute psycho- pathic hospitals have been established in some of the large cities in connection with the principal general hospitals. In these institutions patients afflicted with mild and curable forms of mental trouble receive treatment without being regularly committed to an ins.ane asylum. Such are the insane pavilions in Bellevue and Kings County hospitals, in New Y'ork. Sec Nurses, Trainin<3 OF. Consult Burdett, Tlic Hospitals and Asy- lums of the World (Loudon, I89I). MiLiT.RY Hospitals. These are hospitals de- signed and erected for the exclusive use of soldiers, and in some instances sailors, including every form of establishment, from the field dressing sta- tion, or first hospital, kee])ing pace with the firing line, to the permanent institutions of the home country. Naturally, military hospitals are of comparatively recent origin; horn of the needs of warfare, and the advance of medical science and hj'giene. In the Crimean War of 1854 the French alone of the allied powers possessed any- thing approaching the equipment now common to all armies. The English wounded were carried ofl' the field in rough-and-ready fashion, sailors' hammocks being ultimately utilized as a rude substitute for the French stretcher and ambu- lance. Surgeons dressed the wounded on the field, for whom there was little or no after ac- commodation, until, spurred by the publication of Florence Nightingale's description of condi- tions, and the reports of special committees, the Government appointed Lord Herbert's commis- sion, which resulted in more effective hospital service. Similarly, the great Civil War of Ameri- ca in 1861 may be said to be the parent of the present United States Army Hospital Service, if not also of the entire European system, the Eng- lish branch of which proved so effective in the Boer-British War of 1899. The dread of soldier and sailor alike, and the equal despair of the surgeon, had up to 1861 been a swift and often fatal form of gangrene, peculiar to naval and military hospitals; this, with many other equally deadly phases of the old system, was effectually remedied during the Civil War. The desperate character of the fighting taxed the general surgi- cal capacity of the nation ; and with the gradual advance in hygiene, bacteriology, and antiseptic surgery, undoubtedly led to the comparative per- fection of to-day. Permanent and Field Hospitals. Modem militarv' hospitals may be divided into two general cla-sses — permanent, and war or field hospitals. To the former belong the hospitals attached to army posts and permanent military stations, as well as such institutions as the General Military • Hospital, Fort Bayard, N. ^I. ; Netley Hospital, England ; and the Val-de-Grace. Paris. France. The United States Army shares with the Na^-y the advantages of the general hospital at Hot Springs, Ark., which is set apart for patients suffering from such diseases as the waters of the hot springs have the reputation of benefit- ing, except that cases of venereal diseases are not admitted. Admission to this hospital is re-