Hospital construction and management

Front matter

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Hospital Construction and Management.

Construction and Management

Preface

THERE is no systematic work in the English language on the arrangement, management, and construction of hospitals, in their hygienic, administrative, and structural relations.

The present is, we believe, the first attempt in any language to treat the whole question in a strictly logical manner, by considering primarily the principles necessary to be observed to fit them to fulfil their purpose ; and then by applying those principles to practice, so far as they are accepted by the leading authorities on the subject.

All hospitals are intended for the relief of suffering, the cure of disease, and the repair of injuries — their raison d'etre is, consequently, based on medical and hygienic grounds, which need medical knowledge and experience for their right understanding.

Hence, this portion of the work has been undertaken by a member of the medical profession, who has for many years, in his official and private capacity, devoted special attention to the question in each and all of its aspects.

For the architectural portion the responsibility rests with a member of that profession, who has had considerable personal experience in hospital construction and arrangements ; who has made himself practically acquainted with the best recent types of hospitals in Europe; and who has thereby been enabled to form independent opinions as to what to do, and what to avoid, in the practical working of this great question.

The issues in the two sections of the work differ essentially in character. In the medical relations of the matter, some of the principles involved must be more or less speculative in character, inasmuch as the problems of life and death, health and disease, the loss of the one and the recovery of the other, are still, and must probably for ever remain, beyond the iv Preface.

reach of rigorous solution by any means of investigation or instruments of research in our possession.

Not so mechanical and physical agencies, most of the relations of which can be determined with some approach to mathematical accuracy.

Hence, of necessity, greater precision in the practical application of the principles, than in the determination of the principles themselves, to be observed in hospital construction and arrangement. Not the less important, nevertheless, is it to indicate those principles so far as they are at present ascertained and accepted, and to subordinate the structural arrangements to their right interpretation.

The history of the efforts made in Paris for a century past, since the right path was indicated by Tenon in 1788, to reform the Maternities of that centre of civilisation, is an instructive example of the criminal folly of disregarding the counsels of those alone capable of guiding and directing public opinion in such matters, and of the lamentable as well as needless sacrifice of human life which has been, and still continues in some institutions to be, the result.

We believe that this attempt to submit the whole question in a strictly logical form to the consideration of the professions most immediately concerned, and to the public, which has so deep and abiding an interest in all that relates to the sick and suffering, is a step in the right direction.

We are not without hope that, however imperfect it may be in design and execution, it will prove useful to the numerous authorities engaged in the administration and direction of the public and private charities of the country, amongst which none demand or receive more earnest and devoted attention than those to which this work direCtly relates.

It was originally intended to make the work a complete representation of the hospital systems of the civilized world, with typical and illustrative examples of the best-known and most recent models in existence of such institutions. It has been found, however, that to collect the materials for this purpose would necessitate very considerable delay — a postponement of publication so considerable, in fact, as to be altogether inadvisable. We have, therefore, determined to publish at once so much of the materials as we have been able to digest regarding the principles to be

Preface.

v observed in the management and construction of such institutions, with descriptions and illustrations of the most advanced types to be found in Europe generally.

As respedts the United States of America, we are promised plans of the Johns Hopkins’ Hospital, of Baltimore, fast approaching completion, and shall content ourselves with this example of the most advanced views of our Transatlantic brethren, inasmuch as the general description of the hospitals of America will, we understand, be undertaken by the most competent of all authorities on the subject, Dr. J. S. Billings, the learned and accomplished author of the Baltimore plans.

F. J. Mouat,

Athenaum Club.

H. Saxon Snell,

22 Southampton Buildings, London.

Contents

Sections I and III.

By F. I. MOUAT, M.D.

I. — The Principles of Hospital Construction and Management in Relation to the Successful Treatment of Disease. Illustrated by several Woodcuts.

Table Of Contents

Section I.

Preface ...

General Introduction to Sections I and III. ...

Introduction to Section II

Herbert Military Hospital. Woolwich, England Principal Sick Wards

Blackburn and East Lancashire Infirmary, England Principal Sick Wards Leeds General Infirmary, England Principal Sick Wards St. Thomas's Hospital, London ...

PACE

... iii to v ... i to 7 7 9

... 12

... 22

38 40 43 45 49

... 60

... 62

65 70 75

... 76 i to ii 3 7 11

X

Table of Contents

Royal Infirmary, Edinburgh, Scotland ...

Glasgow Western Infirmary, Scotland ...

Norfolk and Norwich Hospital, Norwich, England

St. Marylebone Infirmary, Notting Hill, London Principal Sick Wards Extracts from Official Documents as to the Construction of Workhous St. George’s Union Infirmary, Fulham Road, London Pavilions Generally Administrative Offices Principal Sick Wards

Hull General Infirmary, Yorkshire, England ...

Mons Civil Hospital, Belgium ...

Antwerp Civil Hospital, Belgium

Heidelberg University Hospital, Germany Surgical One-storied Pavilions Medical One-storied Pavilions Medical Four-storied Pavilions Surgical Four-storied Pavilions Berlin Civil Hospital ...

Surgical Pavilions Medical Pavilions...

Infectious Wards ...

Berlin Military Hospital, Templehof, Germany Principal Sick Wards Isolation Sick Wards

Konigsberg Military Hospital, Germany Dusseldorf Military Hospital, Germany Ehrenbreitstein Military Hospital Germany ...

Custrin Military Hospital, Germany Dresden Public Hospital, Germany The Mutterhaus ...

The Pavilions

Strasburg University Hospital, Germany Wards of Central Block Pavilion Wings

The Moabite Barrack Hospital, Berlin, Germany

Halle University Hospital, Germany ...

Medical One-storied Pavilions Surgical One-storied Pavilions Isolation Pavilion...

Lariboisiere Hospital, Paris, France Principal Sick Wards Puerperal Fever Wards Hotel Dieu, Paris, France Principal Sick Wards

Infirmaries

PAGE

130 132

139 205 207 210

Table of Contents.

xi

Tenon Hospital, Menilmontant, Paris, France ...

Principal Sick Wards The Maternity

St. Denis Hospital, France Principal Sick Wards Bichat Hospital, Paris, France...

Principal Sick Wards ... ... __ ...

Bourges Military Hospital, France Principal Sick Wards

Saint Eloi Hospital, Montpellier, France Principal Sick Wards Utrecht Hospital, Holland Amersfoort Military Hospital, Holland Summer Sick Pavilions Winter Sick Pavilions

Hospital of St. Andrew the Apostle, Genoa, Italy Principal Sick Wards Riga Town Hospital, Russia List of Riga Hospitals Principal Sick Wards

Nativity Hospital, St. Petersburg, Russia Principal Sick Wards

Johns Hopkins Hospital, Baltimore, United States ... ... .%.

Principal Sick Wards M. Tenon’s Proposed Hospital ...

Takhtsingji Hospital, Bhavnagar, India Principal Sick Wards

Burdon Sanderson's Proposed Hospital Ward ...