patients,—each pavilion to be 115 feet long, by 24 broad and 14 to 15 high, to contain 34 to 36 patients, and to have windows to the ceiling. These proportions would give 77 to 80 square feet of floor Bpace, 64 to 6ij feet of wall space, and 1080 to 1200 cubic feet of total space, an immense advance upon then existing arrangements. The Revolution put a stop to those projects, and half a century elapsed before a pavilion building, as now understood, was actually constructed. Curiously enough, revolution again stepped in to arrest the movement, for the first building of the kind, the Hopital Louis- Philippe, was begun in the last years of that monarch s reign, and suspended in consequence of the revolution of February 1848. Some years later, in 1854, it was completed and renamed Lariboisiere, from the name of the benefactress whose munificence helped to bring it to a successful conclusion. The building is oblong, enclosing a space in the centre, the front (south end) containing the adminis tration, and the opposite (north) end the chapel, kitchens, &c. From the two sides the pavilion wards jut out. The building is on the whole not a good one ; the distance between the pavilions is only half what is required, and the wards are frequently overcrowded. Unfortunately most of the defects, with some additional ones, have been reproduced in the new Hotel-Dieu. The new hospital at Menilmontant, in the north-east of Paris, is also a pavilion one, differing somewhat in detail, but of great size, each pavilion having numerous stories. The military hospital at Vincennes is a good specimen of modern construction. A small experimental pavilion, built on the suggestions of Dr Tarnier in the garden of the Mater- nite in Paris, merits notice. It consists of two stories, each con taining four wards for one parturient woman each. The kitchen, office, &c. , are in the centre, but the only access to each ward is by the verandah direct from the open air. The walls, floors, and ceil ings are non-absorbent, and there is a space of 56 cubic metres, or nearly 2000 cubic feet for each inmate. The chief objection is that there are no means of ventilation except by the door or window ; otherwise the plan is excellent. This plan of making each ward open directly from the open air was proposed by the late Sir James Simpson, as a means of improving the sanitary state of existing old hospitals. The plans of M. Toilet ought not to be passed unnoticed. In addition to the ordinary principles of pavilion construction, he insists upon the ogival or Gothic form of architecture, which he thinks was adopted in the Middle Ages as much for sanitary as for architectural reasons.
In England the question of hospital improvement slept until the disasters at Scutari, in 1854-55, roused the attention of the Govern ment and the public to the necessities of the case, and the report of the Army Sanitary Commission and of the Barrack and Hospital Committee, and Miss Nightingale s Notes on Hospitals, led the way in advocating hospital reform. Unfortunately just before this movement the plans of Netley Hospital were made, and the build ing begun on the corridor system. Efforts were made to arrest its progress, but unhappily without effect, and the country which has led the van in sanitary science has as its chief military hospital a building far from satisfactory. The first pavilion hospital in England was the Blackburn Infirmary, built rather more than twenty years ago. The pavilions are there at right angles to a centre corridor, and are alternate ; a similar arrangement is followed out at the Children s Hospital at Pendlebury, near Manchester. St Thomas s at Westminster Bridge consists of a row of parallel pavilions united by a corridor at one end. A plan practically identical was proposed for a new hospital at Valetta (Malta), but this building, though frequently referred to in books, has never been constructed. The Herbert Hospital at Woolwich consists of parallel pavilions jutting out from the sides of a centre corridor at right angles ; although it is now nearly twenty years old, it is still one of the best examples of a pavilion hospital. The latest pavilion hospital is the New Royal Infirmary at Edinburgh, to which reference has already been made. Every care seems to have been bestowed on its construction and arrangement ; the space allowed per head is ample and the site excellent.
In Germany the Fnedrichshain Hospital at Berlin is one of the best specimens of a pavilion building. The pavilions are 160 feet apart, six two-storied and four one-storied, with isolation wards and the necessary administrative buildings. The hut hospital erected during the late war at Tempclhof near the same city was a good example of how the pavilion system may be indefinitely extended, the huts being placed in echelon in wide zigzag lines.
In America great attention has been paid to the question of hospitals, especially since its importance was so roughly thrust upon the country s notice in the great civil war of 1861-64. During that time numerous plans were tried, and among others the old plan of Petit, Poyet, &c., namely, radiating pavilions from a circular or oval centre, which contained the offices and administration. This pl;in was found not to be a good one, as it interfered with both lighting and ventilation. The earliest American hospital of any size was the Pennsylvanian Hospital of Philadelphia, which was begun in 1755, under the auspices of Dr Thomas Bond and Benjamin Franklin, and finished in 1805. It was also in Philadelphia that the first pavilion hospital of a permanent character was erected, the corner stone being laid in 1860 ; in it the pavilions are parallel, two stories besides basement and attics. The space allowed is ample, but the wards are too wide, nearly 31 feet. In New York there is a large amount of hospital accommodation—about 6000 beds, or about 1 in 1500 of the population. The New York Hospital new pavilions give 112 square feet of floor space and 1800 cubic feet of total space. The Roosevelt Hospital has somewhat the same dimensions, but with a much greater space for surgical patients. One peculiarity of arrangement in that building is that the closets are not at the end of the wards as usual, but in the centre, grouped round a central shaft which extends through all the stories, cellar and basement. In this the water and steam pipes are placed, as also the foul linen shafts ; the closets are cleaned by a steam jet. This plan does not seem very commendable. The Massachusetts General Hospital at Boston is the oldest in America, except the Pennsylvania Hospital. Since 1872 four new pavilions have been built on peculiar plans : two are square, one containing one large ward for 20 patients, and the other divided into smafl rooms of 2 beds each, giving each about 97 feet of floor space and 1500 to 1850 feet of total space ; the other two are oblong, divided into rows of single rooms, with a dividing corridor, something like an arrangement of prison cells. The floor space is about the same, with less height. The Johns Hopkins Hospital at Baltimore will be memorable for the care bestowed upon the consideration of its plans. The one finally adopted is on the pavilion principle, scattered over a wide space of ground.
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