of each sex. A second plan is that of a larger but still small hospital for six patients, with separation of sex, and also of one infectious disease from another. The building is a long narrow one, and should face north and south if the site allows. The men's wards have a verandah on one aspect, the women's on the other. The roof of the verandah is so planned that it does not run close to the eaves, but to a point which marks the division of the window into sash and hopper. The wards and the nurses' rooms open direct on to the verandah; this is surely objectionable, and the addition here of a lobby would be an improvement.

The third and fourth plans are here reproduced, the one being a plan for a pavilion of twelve beds, the other being a plan of a block for ten beds. In all these plans provision is made for 144 square feet of floor space, 12 linear space of wall space, and at least 2,000 cubic feet of air space per bed. The block plan would be improved by the addition of lobbies to the doors opening into the verandah, and one or two windows for the purpose of better ventilation in the long blank wall of the end wards. The absence of a proper bath-room also invites criticism. Nor in cold weather will it be very comfortable for patients well enough to move about to have to brave the cold draught in the verandah to use the closet; but these details evidently admit of remedy.

It is, lastly, to be mentioned that the four plans all presume that the boundary fence is at least 40 feet from the hospital buildings.

(419) The Superintendence and Management of Hospitals.

The principles of the management of infectious hospitals are, so far as daily routine and discipline goes, no different from those of other institutions, but there are special points to be considered with regard to preventing the spread of infection by the nurses, attendants, patients, visitors, and their friends.

The following rules,1 adopted by the Asylums Board, are all that in practice will be found to work; if rules are too stringent they fail from impracticability. The Asylum Board rules are good

1 These rules are extracted from the Manual of Regulations of the Asylums Board. Of course the rules selected are only those which are in one way or the other connected with infection.

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common-sense precautions, and may be well taken as a model, little details being altered to suit local requirements:

(420) Duties of Nurses.

To see that the clothing found upon each patient is sent to the disinfecting room.

To see that all soiled and dirty linen be set aside, and sent to the patients' laundry at the earliest possible opportunity.

In every case of death to superintend the washing, laying out, and shrouding of the corpse, and to give orders for its removal to the mortuary.

To be careful that all dust, rags, and combustible refuse of any kind from the wards are burnt, and not thrown into the dusthole.

(421) Duties of the Laundry Superintendent.

To see that all articles are placed in the disinfecting tanks separately, and not in bundles.

(422) Duties of the Gate Porter.

To keep the gates, and to prevent any person not being a principal officer of the hospital, or a visitor to a principal officer, or an officer of the Board of Management, an inspector of the Local Government Board, a minister of religion, or any other person authorised by law, or by the Local Government Board, or Board of Management, from entering into or going out of the hospital without the written leave of the medical superintendent, or of the steward or matron acting under his authority.

To keep a book to be supplied by the Board of Management, in which he shall enter the name of every officer, and the name and business of every other person who shall go into or out of the hospital, together with the time when such officer shall go in

or out.

Not to allow any male or female subordinate officer to pass the gates in the uniform or dress worn in the hospital.

To understand that unless a patient's name is entered in the visiting book as being in a dangerous condition, he or she is progressing favourably.

The contractors are not to employ in the delivery of stores at the hospitals any person who is not certified by the medical superintendent as having been efficiently vaccinated or revaccinated. The gate porter will see that the conditions of this resolution are complied with.

(423) General Regulations.

No member of the staff is permitted to leave the hospital premises without having first entirely changed his or her wearing apparel.

Nurses and those attending patients are to be permitted to leave the ward half an hour before leave commences, for the purpose of entirely changing their wearing apparel, and if possible taking a bath.

(424) Regulations as to Condition of Patients.

Upon the admission of a patient, a letter with a copy of the regulations is to be sent to the nearest known relative or friend, setting forth the state of the patient; should any serious change for the worse take place, a letter is to be sent daily to the relative or friend, stating how the patient is progressing, which letter is to be continued until the patient is in such a condition as to render further communications unnecessary; but should the patient become dangerously ill, notice is to be sent by the steward of the hospital to the nearest known relative or intimate friend, with an intimation that the patient may be visited; and the steward may, at the discretion of the medical superintendent, and subject to the approval of the Committee of Management, make arrangements for the conveyance of the visitor to and from the hospital.

Applications for information as to the condition of patients must be made in writing to the medical superintendent, who will reply by return of post. It is very undesirable that friends of patients should personally make inquiries at the hospital.

(425) Visiting.

The visiting of patients is to be limited to the nearest relatives and intimate friends of patients dangerously ill. One visit only