We have been greatly interested in a correspondence which has been going on in the columns of the Scotsman, in reference to building the new Royal Infirmary at Edinburgh. The parties to this discussion are Professor Syme, and Sir James Y. Simpson. Mr. Syme is in favor of a large building, placing the utmost reliance in disinfectants for preventing the spread of disease, and those evils to which all such institutions are occasionally liable. The disinfectant upon which he chiefly relies is carbolic acid ; but Sir James Y. Simpson denies its efficacy. The latter states that during the two years in which it has been employed the mortality from amputation has increased from forty to fifty-three per cent. Instead of the large buillings hitherto employed as hospitals, with their numerous wards, bedrooms, etc., he advocates a central building for the administrative part of such an institution, and the erecting upon the ground around about this central building a series of village hospitals or wards, furnished with the latest and best sanitary improvements. He claims that in the construction of such buildings the great disinfectants and antiseptics that we should alone depend on are abundance of space, abundance of light, and above all, abundance of fresh, pure, and ever-changing air to every patient in every ward. He is right. During the recent war wo saw an admirable test of the correctness of his views. It was our privilege to contrast daily for a long period, the sanitary condition of patients crowded together in a large hospital, and others distributed in smaller buildings at considerable distance from the main hospital, used to supplement the accommodations of the larger building. The increased comfort, and the improvement in the condition of the patients in these smaller wards were so marked as to attract the attention of, and elicit considerable remark from the surgeons in charge. The huddling of people together, even when all are healthy, is attended with increased liability to disease. How much must such liabilities become exaggerated when the air is loaded with foul effluvia and exhalations, sickening even to healthy attendants, and which together form an odor charac teristic of every hospital we ever entered. Best of all restoratives are light, pure air, andurest, such as never can be secured to patients crowded together in large wards and forced oftentimes to witness involuntarily sights which, to those not inured by long familiarity with suffering and disease, are harrowing in the extreme. We believe that were the suggestions of Sir James Y. Simpson adopted, a great benefit would be conferred upon suffering humanity.
This article was originally published with the title "The Rational Construction of Hospitals" in Scientific American 21, 21, 329 (November 1869)