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south, 12 in the east, 8 in the west, and 8 central. This arrangement, according to their localities, is that adopted by Mr. Low, from whose very valuable book, "The Charities of London," has been derived the very greatest assistance in the compilation of this chapter on Hospitals, and particularly as regards the dispensaries and minor medical charities. Of these general dispensaries 13 existed in the year 1800. In the year 1849 they relieved 141,000 patients. Their incomes amount to 14,424/.; from contributions, 11,470l.; from property, 29541.

The MISCELLANEOUS MEDICAL INSTITUTIONS, which are not included in the above classes, are some 21 in number. They are establishments of various kinds, and under various names, as asylums, infirmaries, dispensaries, &c., which do not receive inpatients such are institutions for delivering women at their own homes, Truss Societies, Asthma Infirmaries, Vaccine Institutions, Institutions for diseases of the Skin and Ear, &c. Of these four existed before the year 1800. In the year 1849, 67,000 patients partook of their benefits.

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Institutions which are merely sanitary, that is, for preserving health, or merely humane, and only distantly relieving ill-health; all mere asylums, and houses of nightly shelter, have been excluded in the above enumeration. This part of the work is strictly confined to a description of what may be called sanatory or disease-curing institutions, in contradistinction to "sanitary," or preserving-health establishments. Of these sanatory institutions there are about 100, all of which, having been now classified and noticed above, will be described individually, more or less in detail, in the following pages, and for convenience they are not arranged in classes, but alphabetically. It will be advisable, however, to premise a few observations upon the general state of public medical relief in London. This is of course a very different subject from that of public hygiene, which has been treated of elsewhere. The first remark which would be made by a foreigner would probably be one expressive of surprise at the very few public hospitals which depend upon government support; whereas, this is far from being the case in most continental cities. In Paris, for instance, all places of public amusement are taxed for the support of hospitals to a tenth part of their receipts, and there is a tax also on cemeteries for the same purpose. Perhaps, in the next place, he would be struck by the very large number which are supported by private benevolence; but he would soon recollect that his remark would equally apply to almost all our other great institutions, whether for purposes of education, amusement, police, roads, &c. The greater number of these, though not, as in the case of hospitals, depending upon voluntary aid, are yet generally independent of assistance from the state, in other words, they are paid for out of the self-imposed taxation of the parish, borough, or county, and not from the Consolidated Fund of the general property of the country. Hospitals,

however, are certainly removed from government aid to a still greater degree than any of the above-named institutions, and are equally unmodified by government control. There is in London no Bureau Central d'Admission to point out into which hospital the patient shall go; no general administration, with an administrative committee, and a consulting committee of advocates to regulate the affairs of the hospitals and asylums, as at Paris. Everything seems to go unregulated and at hap-hazard; but whatever good effect this central authoritative control may be productive of in other countries, it is very doubtful whether, with our habits, it would be otherwise than prejudicial here. It would introduce, no doubt, a more uniform and systematic method of treatment, would add valuable statistical information more readily, and would, perhaps, discover wants, and point out the way to supply them more quickly. But it would take away a great part of that incentive to popular and extended interest being felt in them, which the management and supervision of the outlay of our own property always generates; and which, as being part of a system opposed to that of centralisation, and one which seeks to be as free as possible from legislative restraint, is at least well fitted to the genius and habits of this country.

The next thing which would strike the foreigner would probably be the small extent of hospital accommodation; and, indeed, of sanatory institutions generally in proportion to the enormous population of this metropolis; and particularly he would notice the almost entire absence of Maisons de Santé, that is, hospitals into which patients of the better classes are received at certain rates of payment. Paris, with less than half the population, has one-third more hospital beds than London. This fact, however, results rather from the domestic character of the Englishman than from any other cause. As for recreation and during health he prefers home, so, during sickness, he has a dislike to any other place; among the very poor also it must be confessed that there is a great prejudice against hospitals, as they have a suspicion that they are enticed there as much for the purpose of experiment as from motives of humanity. Mixed with prejudice, however, as this feeling against going, during illness, into a public institution may be, it is undoubtedly, on the whole, a sound one, and is among us so closely connected with the feeling of independence of charity and domestic habits, that it is, perhaps, not to be desired that the proportion of deaths in hospitals to the whole number of deaths should increase. In Paris this proportion is 30 per cent., in London only 5. It is also to be observed that the provincial hospitals in France are not so numerous when compared to those of Paris, as are the country hospitals here when compared with those of London. Without, perhaps, going so far as Montesquieu, there is yet a great deal of truth in his saying in the Esprit des Lois, "Malheur, malheur, au pays qui a beaucoup d'hôpitaux;" and he considers that Henry VIII. by destroying the abbeys, hos

pitals, and houses of refuge, laid the foundation of the future prosperity of this country, by calling forth the resources and energies of the poorer classes, who were no longer able to find the ready charity they had been accustomed to.

The sanatory statistics of hospitals for the year 1849 are the following:-The total number of in-patients treated in all the hospitals was 42,360. The out-patients amounted to 535,000.

The financial condition is as follows:-The united incomes of all these institutions amounted to 264,000l.; of this, 184,000l. arose from the interest of property; 80,000l. from voluntary contributions.

The

In respect to the progress of hospitals during this century, it has been seen that in the year 1800 there were 33 public sanatory institutions of all kinds; there are now upwards of 100. They furnished in that year 3230 beds; they have now 6226. population of London was 900,000; it is now more than 2,000,000. So that in proportion to the population the number of beds has remained stationary, while the number of institutions receiving outpatients only has increased in a far greater proportion.

The following alphabetical list of hospitals described in detail is arranged according to the most distinctive word in the general title of each institution. The SPECIAL INSTITUTIONS under the word expressive of the special disease or class of persons for which they are intended; and the GENERAL DISPENSARIES under the word Dispensary in alphabetical order.

Bartholomew's (St.) Hospital, Smithfield.-The oldest hospital in London. Founded by Rahere, minstrel to Henry I., and first prior of St. Bartholomew, with which priory it was connected in 1113, 1123, or 1133. (See also pp. 131-135.) Repaired 1423, by the executors of the celebrated Richard Whittington. Passed, on the suppression of monasteries, 1537, to Henry VIII., who, on the petition of Sir Richard Gresham, refounded it in 1547 by royal charter. It has been enlarged and partly rebuilt at various times; the Smithfield gate was built, 1702; the great quadrangle by Gibbs, 1730; the anatomical theatre in 1822 and 1835; the surgery in 1842. It contains a portrait of Henry VIII.; one of Dr. Radcliffe, by Kneller: one of Perceval Pott, by Reynolds; and one of Abernethy, by Lawrence. The staircase is painted by Hogarth. All diseases are treated, and there is a large surgery, &c., with operating theatre, open at all hours. A Samaritan fund for relieving poor deserving patients with food, clothes, and money, on quitting the hospital, was founded in 1845; the funds for its support are distinct from the revenues of the hospital, and depend solely on voluntary contributions.

The government is vested in the Lord Mayor and Aldermen, 12 Common Councilmen appointed by their own body, and such other persons as should be chosen at the general courts. The present number of governors is 339, and the qualification a gift of 100. The greatest benefactor was the celebrated Dr. Radcliffe, who left

600l. a year. committee of governors. A medical school is attached, in which lectures on all branches of medicine and surgery are given; and there are valuable museums, libraries, reading rooms, &c. In 1843 a collegiate establishment was founded for affording medical instruction with general and moral superintendence and residence within the building. Four scholarships, each tenable for three years, and of the annual value of 451. or 50%., are obtainable.

The Samaritan fund is administered by a special

The medical school is said to have been in existence, and gradually increasing in importance, ever since 1662. The eminent names connected with it are those of the celebrated Harvey, who was physician from 1609 to 1643, Perceval Pott, Dr. W. Pitcairn, Dr. David Pitcairn, and Abernethy, all medical officers and lecturers.

Patients are admitted on Thursdays at eleven; cases of urgency at any time. There are 580 beds. In 1848 there were 5826 inpatients; 19,149 out-patients; and 46,598 casualty: in all 71,573. The income is about 32,000l.; 5007. of which is from voluntary contributions.

The medical officers are-Dr. C. Hue, Dr. G. L. Roupell, Dr. G. Burrows, Dr. F. Farre, Dr. H. Jeaffreson, Dr. Patrick Black; W. Lawrence, Esq.; E. Stanley, Esq.; E. A. Lloyd, Esq.; F. C. Skey, Esq.; T. Wormald, Esq.; J. Paget, Esq.

Bethlehem Hospital, Lambeth, is described elsewhere. It must, however, be included among the Special Hospitals, being dedicated to the reception and treatment of the insane. It was founded in 1546. The present building was opened in 1815. The number of beds in 1800 was 270. In 1849 the number of beds was 450; the patients admitted amounted to 330 the average yearly number being 400.

The income is 16,000l.

Medical officers-Dr. Monro, Sir A. Morrison, and W. Lawrence, Esq. Clerk, B. Welton, Esq. (See "Lunatic Asylums.")

Charing Cross Hospital, King William Street, West Strand. of the 12 General Hospitals. Founded in 1818. Present building erected 1831. By this institution not only are patients treated both as out-patients and in-patients, but such as require it are attended at their own homes, particularly midwifery cases, and children suffering under contagious disorders. The governors are donors of 40 guineas; the life-supporters of 20 guineas; an annual subscriber of 2 guineas may recommend an in-patient, an annual subscriber of 1 guinea, or a donor of 10 guineas, may recommend 3 out-patients.

In-patients with letters admitted on Mondays at 12; accidents at all times immediately.

There are 118 beds. During 1849, 18,500 patients were treated, 1200 being in-patients.

The annual revenue is about 2500l., almost entirely from voluntary contributions.

The chief medical officers are-Dr. Shearman, Dr. Golding, Dr. Chowne; H. Hancock, Esq.; J. Avery, Esq.; M. A. Canton. Hon. Secretary, J. Robertson, Esq.

Chest, City of London Hospital for Diseases of the, 6, Liverpool_Street, Finsbury. Established 1848. A special dispensary, open daily. Patients during 1849, 900; Income from contributions, 1000l. Hon. Sec., D. H. Stone, Esq.

Chest, Dispensary for Consumption, and Diseases of the, 26, Margaret Street, Regent Street. Established 1847. During 1849 upwards of 5000 patients were relieved. Hon. Sec., W. T. Hudson, Esq., 61, South Audley Street. Children, Royal Infirmary for, Waterloo Bridge Road. Instituted 1816. It is intended for affording prompt relief, without recommendation, to children under 14 years, and also to their sick mothers. In 1849, the number of patients was about 5000. Secretary, E. Meymott, Esq. 34, Stamford Street.

Children, Tower Hamlets and General Dispensary for, 50, Worship Street. Established 1845. During 1849 there were 325 patients. Secretary, J. Watson, Esq.

Consumptive Hospital, Brompton, instituted 1841; incorporated 1849. A hospital especially devoted to consumption and diseases of the chest. It was formerly in Chelsea; but, in 1846, the patients were removed to the present new and handsome building, much to the advantage of their health. The Rose charity fund is a Samaritan fund, similar to that at St. Bartholomew's. A donation of 30 guineas, or a yearly subscription of 1 guinea, constitutes a governor. Among the chief benefactors of this valuable institution is Mademoiselle Lind. Persons, with recommendation as in-patients, may attend daily at 2 o'clock; out-patients daily at 1 o'clock.

There were 282 in-patients during 1849, and 2800 out-patients. Income from contributions, 4000l.; from property, nil; expenditure, 4400/.

Medical Officers Drs. J. Forbes, C. J. B. Williams, W. H. Walshe, G. H. Roe, T. Thompson, G. Cursham, R. P. Cotton, R. Quain, John Hutchinson, M.D. Secretary, O. P. Cross, Esq.

Convalescents, Metropolitan Institution for. Office, 32, Sackville Street. Established 1843. The hospital, especially devoted to convalescents, is at Carshalton, Surrey. A donation of 107. 108., or a yearly subscription of 1. 18., constitutes a governor. Patients admitted upon the recommendation of a governor, and in some cases by the payment in addition of 128. per week, every Friday, at 4 o'clock. During 1849, there were admitted 568 patients. Medical officers-Drs. McIntyre and Bell; W. S. Lucas, Esq.; J. T. Warre, Esq.; E. Wallace, Esq. Secretary, J. Johnston, Esq.

Dispensary (Blenheim Street Free), 1, Blenheim Street. Established 1834. No recommendation is necessary. During 1849, number of patients, 5000. Hon. Sec., N. Bennett, Esq., 7, Furnival's Inn.

Dispensary (Bloomsbury), 62, Great Russell Street.

Instituted 1801.

Patients during 1849, 3408. Income, 700l.; from property, 360l.; from subscriptions, 340.; expenditure, 7001. Secretary, G. Stone, Esq.

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