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alone worth a visit to the hospital. There are four, all masterpieces: "The Good Samaritan," The Pool of Bethesda," "Rahere as founder of the hospital" and "A sick man borne by monks." For this labor of love Hogarth was made a governor for life. Quite as famous but less interesting is Guy's Hospital, founded in 1724 by Thomas Guy. It covers an area of six acres and the severity of its buildings is tempered by the many green and shaded spots in the grounds, making it withal, one of the pleasantest spots in London. In wandering through its wards and grounds, I was strongly reminded of the Pennsylvania Hospital in Philadelphia and Bellevue Hospital, New York. The wards are now gradually being altered to conform to modern ideas; the floors are mosaic or teak-wood, the walls tile or glazed cement and the corners and angles rounded. The operating rooms have also been altered and are essentially up to date with the important exception that hand faucets are still used. It can be said however that Guy's is more progressive than any of the other old hospitals of London, and some of the more modern ones, Saint Thomas for instance, which has been built but little over thirty years. On the other hand Saint Thomas excels all the other hospitals in situation and architectural beauty. Built on the pavilion plan, its seven massive buildings and the medical college overlook the Thames, with the Houses of Parliament on the opposite embankment. The buildings are united by arcades in front and separated from the river by two broad esplanads. Its wards are spacious and lofty and it is refreshing to see the expansive halls and open grounds after the cramped conditions which are everywhere encountered in London.

The amount of work accomplished by these three institutions is enormous. They each have about 600 beds; Saint Bartholomew treats about 145,000 out-patients annually; Saint Thomas 80,000 and Guy's, 76,000. Many hospitals have recently appointed, in connection with their out-patient departments, what is known as an "inquiry officer," whose duty is to prevent, as far as possible, any abuse of charity by persons who are able to pay a surgeon. There is not nearly as much "dispensary abuse" here as in our American cities. Whether it is due to this inquiry system I am unable to say, but judging from the report of Guy's hospital for 1898, that alone could not account for it. During that year the claims of fifty-four persons were rejected and 76,211

patients treated. A far greater percentage than that is rejected annually, in a peremptory manner, in nearly every American clinic and leads one to wonder what percentage of rejections an inquiry system would produce and incidentally, its effect upon the finances of our institutions and physicians.

The ambulance system in vogue in London has surprised and puzzled us greatly. In front of some hospitals, not all by any means, may be seen a vehicle which is really a stretcher mounted on two small wheels. This is called a "hand ambulance" and so far as I can learn is the only kind in use. In case of an accident, a policeman or anyone who happens to be about, obtains a stretcher and pushes the patient to the nearest hospital. No case, whether it be a serious accident, a poisoning or drowning receives any treatment until it reaches a hospital. The interne here sees and knows nothing of ambulance service and cannot see the necessity of the systems in America, but the necessity is shown and even the smallest city has its ambulance and physician to go out with it.

The Royal London Ophthalmic Hospital, widely known as "Moorfield's Eye Hospital" is the most recently built hospital in London and has the advantage of having all the equipments that modern ideas can suggest, and it is undoubtedly the finest institution of its character in the world. It is constructed of stone, brick and steel and in the finishing, as little wood as possible is used. The floors are mosaic and cement except in the wards, where they are of teak. The walls are glazed brick or cement and throughout, the interior has a smooth finish; the angles and corners are modified into rounded surfaces and all the plumbing is exposed. Nothing better can be said of its operating room than that it equals the small operating rooms of the Albany Hospital in equipment and precautions against infection. The outpatient department is huge and admirably arranged and though constructed to accommodate the largest eye clinic in the world, its capacity is often taxed. The great number of patients that come to the clinic daily gives the student all that he can do and often, more than he can do properly. The American student will find his work in refraction unsatisfactory unless he adheres to his American teaching and that he is at perfect liberty to do. I venture to say that in no other clinic will he find a greater number of cases of inflammatory diseases, fundus changes and congenital

anomolies, or be able to examine them under better conditions or follow them more closely in their treatment. He is permitted to perform many operations and continue the after-treatment. Considerable time can be most advantageously spent in following the operative work of Mr. Morton, Mr. Treacher Collins, Mr. Holmes Spicer and Mr. Lawford. The technique of these men is faultless and one is not surprised that accidents are so rarely seen. In cataract operations the loss of a bead of vitreous is the rarest occurrence. I have been impressed with the large number of cases of high myopia operated upon by discission or simple extraction of the lens. Mr. Collins places the age limit for re moval by discission at thirty years; beyond that age he performs simple extraction, but the necessity for the later operation seldom occurs as the patients usually come for relief long before that age. Whether the number of cases of high myopia seen here is absolutely greater than in America, or whether the proportion is the same in relation to the total number of eye-cases seen, I am unable to say. Retinal detachment, the accident to be feared after removal of the lens, in these cases, causes little apprehension here

though it sometimes occurs. Mr. Collins has operated upon twenty cases approximately without a detachment resulting, and his observation in some cases has extended over a period of many years. Mr. Morton has had a similar and more extensive experi

ence.

The Royal Westminster Ophthalmic Hospital in Charing Cross has a clinic a little more than one-third the size of that at Moorfield's, but the student can get an excellent service there under Mr. Frost and Mr. Hortridge. It is not crowded with students and in this respect is better than Moorfield's, though the facilities are much inferior. Moorfield's is justly entitled to the reputation of being the best hospital in the world for the student in ophthalmology to finish his studies and not a small element in obtaining this reputation are the courtesy and attentiveness of the surgeons.

Some of the ophthalmic hospitals and the Ophthalmological Society of the United Kingdom give a "clinical evening" about once a month. Through the courtesy of Mr. Frost I attended onc at the Royal Westminster Hospital in April which was under his supervision. About thirty of his most interesting fundus cases were placed at the disposal of invited surgeons for examination.

This week some rare and instructive cases were exhibited by various surgeons at the Ophthalmological Society and discussed by Mr. Nettleship, Mr. Frost, Mr. Lawford, Mr. Collins and others. This might be a pleasant departure for some of the American societies to consider.

I have seen little of the work in general medicine or surgery or in special lines apart from ophthalmology, but drawing my conclusions from what I have seen and from what I have been told by many keen observers, we have much to be proud of and need be ashamed of nothing in our domain of medical science. HARRY S. PEARSE.

STATE SANITARIA FOR TUBERCULOSIS IN MASSA

CHUSETTS.

308 COMMONWEALTH AVE., BOSTON, MASS., May 17, 1900. TO THE ALBANY MEDICAL ANNALS:

Gentlemen.-You may be interested to know that the Committee on Public Health have reported favorably upon another $150,000 consumptive sanitarium for our State, and the bill now awaits a hearing before the Ways and Means Committee. The Rutland Sanitarium has so aroused and educated the people that they are clamoring for another, and I think we shall get it, and then we shall ask for another and another. I was quite disappointed with the paltry $50,000 your State appropriated for this purpose, but it will serve as an object lesson, and later you will get a more liberal appropriation. The people will demand it, and what the people want. in the end, they get.

Very truly yours,

(Signed)

EDWARD O. OTIS.

In Memoriam

WILIAM HENRY STUART, M. D.

Dr. W. H. Stuart died at his residence, Norwich, N. Y., April 12, 1900. He had been confined to his home for about three months, having given up practice in January. Dr. Stuart came to Norwich in 1871 and has been in active practice ever since, en

joying the confidence of the public and being eminently successful. He was a skilled diagnostician and was frequently called in consultation.

He was born in the town of German, in Chenango County, November 4, 1840. After graduating from the Cincinnatus academy he began the study of medicine in the office of Dr. A. D. Reed, of that village, afterward graduating from the University of Vermont and completing his medical education at the Albany Medical College, graduating in 1861. In the early part of 1862, a few months after his graduation from the Albany Medical College, he began the practice of medicine in Smyrna. Almost immediately, however, he volunteered in the medical service of the Union army and was appointed assistant surgeon of the 27th regiment, New York Volunteers. After that regiment was mustered out he was appointed surgeon of the 143d regiment. Later he had charge of the hospital of the 1st Division, 20th Army corps, a position he held until honorably discharged at the close of the war. Returning, he located in Earlville in 1865, where he practiced until 1871. He then came to Norwich.

In politics Dr. Stuart was a strong Republican and some years ago was active in party work. He was elected county treasurer in 1884 and held the office for one term. He was a member of Norwich Lodge, No. 302, F. & A. M., of the Chenango County Medical Society and the Smith Post, G. A. R., being surgeon of that organization.

November 8, 1894, Dr. Stuart married Mrs. Julia Port, daughter of Mr. and Mrs. C. W. Olendorf, of Norwich. He is survived by his widow and two step daughters.

ISAAC B. SCHAUBER, M. D.

The ANNALS has been informed of the death of Dr. Schauber (A. M. C., 1899), which occurred at his home at Green Island, N. Y., April 10, 1900.

Medical News

Edited by H. Judson Lipes, M. D.

MEDICAL SOCIETY OF THE COUNTY OF ALBANY.-Annual Meeting held May 8, 1900, in Alumni Hall, the President, Dr. Van Allen in the chair. The following members were present: Drs. Applebee, Bailey, Ball, Barker,

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