VILLAGE HOSPITALS.

THERE is one great fault in our medical education: in the great majority of cases, the skill of the young surgeon begins to rust as soon as he settles down into country practice. A young man may leave the College of Surgeons with a very tolerable amount of anatomy at his fingers' ends; he may have made demonstrations on the dead body to the examiners' satisfaction, and he may leave for some country village with his diploma in his pocket; but here, as a general rule, his knowledge of the higher branches of the surgical art begins to fade. And the reason is obvious: the great majority of cases he has to treat among the poor are medical cases. It is a very uncommon thing to find severe accidents happening to the agricultural peasant—or, at least, it has been so; and where they have occurred, the appliances of their homes are so deficient, that as a rule it is the custom to send such cases to the nearest county or borough hospital.

The tendency of this plan is to encourage the hospital surgeon at the expense of the general practitioner in the country; and we may also say at the expense of the poor patient, who often has to be removed for many miles in a rough jolting cart whilst suffering great agony. Moreover, much valuable time is lost in the transit. In manufacturing districts, where machinery at times causes frightful accidents, the local surgeons are in many cases exceedingly skilful and full of resources, for cases of great urgency are occurring every day which must be treated on the spot; and the fact that agriculture is now assuming the form of a manufacture in which complicated machinery is employed, has led to the necessity for a decentralization of our present hospital

system. Such frightful accidents sometimes take place with our steam thrashing and ploughing machines, that the man dies unless he can be treated upon the spot.

Such being the present state of things, we hear with much pleasure that an experiment, hitherto very successful, is being made in the village of Cranley, near Guildford, in Surrey, to establish a Village Hospital. We do not mean some fine establishment, with a fine building and a staff which eats away all the money, but a simple cottage, with half-a-dozen beds and one good nurse and general servant.

This excellent institution was commenced in 1859 by the medical officer, Mr. Napper, working in conjunction with the clergyman of the parish, the Rev. J. H. Sapte, who is the visitor and manager, and has generously provided the cottage.

One very important feature of this hospital is that it is not altogether a charity, the patients paying a weekly sum, the amount of which is dependent on their circumstances; thus the pauperizing influence of a mere charity is avoided, and the strain upon the pockets of almsgivers, already exerted to the uttermost, is not much increased. Of course, some supplementary aid is required; but we are glad to find that the expenses of maintaining this institution are so light that a very small subscription among the neighbouring gentry is sufficient for the purpose.

This Cottage Hospital, which ought to be imitated else

where, is fitted up with six beds, and during the year ending October, 1861, twenty-three cases were received and treated, many of them entailing amputations and other operations of a severe character, the majority of which did well. Those who are acquainted with the workings of our hospitals in large towns are aware that one of the great drawbacks to them is the impurity of the atmosphere. Persons coming from the pure air of the country are always liable to suffer ill-health from the foulness of the air in great cities; but patients taken from the breezy country downs find themselves in the very focus of disease in large hospitals.

Hospital gangrene and pyæmia are the demons of destruction which ever haunt these temples dedicated to Hygieia, and we appeal to any medical reader for a verification of our testimony, when we say that in all great operations the mortality is not less than fifty per cent., the greater part of which is owing to the pestiferous atmosphere which we manufacture by crowding together so many diseased creatures under one roof. The badly wounded agricultural peasant is by the present system transported to a distant city to almost certain death. The superior abilities of the operator avail him nothing, for Nature refuses to work with the surgeon's knife. We have no hesitation in saying that the statistics of a hundred patients in village hospitals would, notwithstanding the comparative inferiority of the operators to the picked men in great metropolitan institutions, show a very much higher percentage of cures than in London, despite the magnificent scale on which hospitals in the latter are conducted. The modest plan on which this little hospital is worked may be gathered from the balance-sheet, made up to October, 1861, by which it appears that the whole expenses for the year were only £140 9s. 7d., whilst the receipts were £177 75. 11d., a state of things which many of our larger hospitals might envy.

We hear that the success of the Cranley Village Hospital has caused similar institutions to be established in other quarters, and this is a matter in which selfish considerations as well as philanthropic ones should weigh with gentlemen living in the country. If the village doctors, by means of the training and experience these village hospitals afford, were all clever operators, very many valuable lives would be saved that otherwise perish. The fee of a London surgeon, if summoned any distance, is so large that none but the

wealthy can afford to meet it. Persons of limited means must go to the nearest town, at a vast inconvenience, for the very same skill they might get by this decentralizing arrangement at their own doors. In the interest of the poor and the middle classes dwelling in the country, therefore, we beg to call the attention of our philanthropic readers to this admirable institution, in the hope that its example may be followed.

Since this article was written these excellent institutions have become quite familiar amongst us. Instead of building almshouses, old maiden ladies institute the greatest charity to the hard-worked stricken by accident or disease.

Cottage Hospitals, labourer when he is

ILLUMINATIONS.

If we are to judge by the standard of the celebration of the Prince of Wales's marriage, the English certainly do not yet understand the art of illuminating. It is true we have not had much practice, as it is but once in the last twenty years that our streets were ablaze with a public rejoicing; but in twenty years the world has been transformed, and we did expect now a little more artistic skill than we witnessed on the marriage of the Queen. But we fear the public at large have no instinct for the beautiful, and do not take kindly to the decorative arts. What acres of bunting and what miles of gas-piping a-light we witnessed during that week, and what distinct impression have they left upon the mind? An Englishwoman will hang her shawl upon her back in such a manner that it shall look like a boy's kite; the Frenchwoman will drape herself with it that it shall set off the figure to the best advantage.

This instance is very typical of our general unhandiness in such matters. How a Frenchman must have raved at the way in which London, for a week, displayed its flags across every street! Inspired by the genius of the washerwoman, enormous pieces of coloured bunting have been hanging from ropes, like so many coloured table-cloths from a clothesline. To the middle-class Englishman a flag is a flag, and the manner in which it is arranged has very little to do with it. Such a thing as grouping never occurs to him, and probably he thinks that to do so would be to hide too much, not knowing that sometimes the half is better than the whole. In some instances, where the clothes-line method of flag-hanging was departed from, even greater absurdities were observable. Thus, at the Ordnance Office, in Pall