St. Luke's Hospital

“ He started for home, but bethought himself.
"Get the wounded rounded up, Koppy. Nobody dead. Just as well. Funerals are a nuisance. Can't see why a bohunk can't sneak off into the bush and die without any bother. If there's more than one speeder load to lug that seventy-five miles to the hospital, there'll be the devil to pay. You and the cooks have your hands full bandaging the rest of the evening, I guess. Come up in an hour and report."
As they toiled up the slope to the trestle Torrance broke a long silence. ”

“ A special children's chnic is held daily at the Jerusalem Hospital Annex. Railway employes' clinics are conducted at Haifa and Ludd.
Voluntary Hospitals. — Palestine is richly endowed with voluntary hospitals, which are situated as follows :
Jerusalem - British Ophthalmic Hospital (English Order of S. John of Jerusalem) . S. Louis (French) Hospital. - Italian Hospital. Rothschild Hospital (A.Z.M.U. or
Hadassa) . English Mission Hospital (London Jews'
Society) . Shaare Zedek, \
Mizghab Ladach, Becur Cholim,
Jewish Ophthalmic Hospital, Leper Hospital (International Moravian Society) . ”

“ The Veterinary Hospital situated in Mamilla Street, Jerusalem, has been taken over by the Society on lease from the Municipality, and is now entirely under the Society's own management. Only those animals are de- tained which are suffering from serious causes. A minimum charge for forage is made and treatment is provided free to animals whose owners cannot afford to pay. The Hospital is under the inspection of the veterinary officials of the Government, and is open to visitors at all times by arrange- ment with the Secretary. ”

“ The Department assumes responsibility for research and education, and, in the absence of text-books of local application and teachers of local origin, land has been secured in the neighbourhood of departmental headquarters in the hope that it will be possible to establish, in due course, a school, laboratories, experiment farm and veterin- ary hospital, where a junior staff may be afforded practical courses of training, which in turn they can pass on to the cultivators. ”

“ During its two years of work for the sick and wounded, no military hospital has succeeded in establishing a finer record. To see it is a wonderful experience. The hospital consists of 17 wards, with 578 beds, and is entirely staffed by women—surgeons, doctors, pathologists, oculists, dental surgeons, anæsthetists, dispensers, nurses, orderlies. The only men are the patients.
Sir Alfred Keogh, the Director-General of the Army Medical Service, said, when speaking of it: “The hospital is in every respect a military hospital, differing in no way from any other military hospital in the country. ”

“ The current system of large hospitals is abandoned, as being equivalent to 'warehousing diseases on the largest possible scale;' while special hospitals are deemed unnecessary—'as if the different organs could walk out of the body and present themselves for separate treatment.' Each hospital has an ambulance ready to be sent out to bring any injured persons to the institution; the ambulance drives straight into the hospital, where a bed of the same height on silent wheels receives the patient, and conveys him or her to a ward. ”

“ A dozen doctors, with each his smattering of patients, can learn and teach but little while they work apart: whereas a regular system of inquiry and record, in action where the sick are brought in in battalions, is the best possible agency. Not only are these objects lost when surgeons are allowed to make the great hospital a mere receptacle for a cluster of small and desultory hospitals, but the advantages of a broad study of diseases and their treatment are lost. ”

“ The glorious halls and corridors, the massive marble pillars, the splendid marble staircases, indicate wealth, but the perfection of the sanitary and scientific arrangements tells of long years of anxious thought and study and research. So perfectly is this marvellous hospital built that, in the event of plague or cholera breaking out to such an extent as to infect the building, the whole of the inside of the hospital can be removed and another hospital will still be left standing as complete as the other. ”

“ Nay, even at the least, the alleviation of suffering to those on whom death had already laid his hand has been no small thing; and when we know that of 240,000 out-patients who have received advice and medicines, and 10,400 in-patients whose cases have warranted their admission to the wards, a large number of actual cures have been effected since the establishment of this hospital, we are entitled to regard the institution as one of the most useful that we have ever visited together. ”

“ It is a curious reflection that whilst in the present war the base hospital has been given, if anything, an undue importance, in the other war it has been practically neglected. Our great hospitals are almost entirely field hospitals, planted right in the middle of the battle, and there we keep our patients till such time as they are to all intents and purposes cured. A very few convalescent homes will admit cases which still require treatment, but only a very few. ”

“ In overcoming this prejudice, a great deal depends upon the character of the institution itself. It is not enough to establish hospitals:—they must be attractive and comfortable to such a degree that they become highly desirable to prospective patients. They must be well run, well managed, the food must be good, and the patients well treated. To obtain segregation, we must have hospitals which offer great advantages over the home.
Home Care of the Advanced Case. If there are no hospital facilities, it then becomes the nurse’s duty to give nursing care to the bed-ridden patient. ”

“ Such disadvantages might be entirely removed if parliament would decide to throw open every poor-law infirmary for clinical purposes, and to have connected with each such establishment a responsible visiting medical staff, consisting of the best qualified men to be found in the community which each hospital serves. The old prejudice against hospital treatment has disappeared, for the least intelligent members of the population now understand that, when a citizen is sick, there is no place so good as the wards of a well-administered hospital. ”

“ The disadvantages, inseparable from general hospitals, are such as can never be counterpoised by all the regularities of medicine and regimen. Nature and kind nursing save a much greater proportion in our plain way, at a smaller expense, and with less abuse. One branch only of hospital institution is wanting with us; that is, a general establishment for those laboring under difficult cases of chirurgery. ”

“ For the great mass of the people, cases of severe illness or injury, or those requiring major surgical operations, can be treated more successfully in well-appointed hospitals than in private houses, and as this is becoming generally understood the old feeling against entering a hospital for treatment is rapidly disappearing. ”

“ Another problem is the question of creating, in connection with General hospitals, wards where patients of this sort may receive at the beginning of their treatment, their preliminary examination, where they may be evacuated home with compensation or without compensation, or evacuated to a prolonged treatment hospital for further care.
It has sometimes been difficult to get enough men, trained personnel, to man these wards. ”

“ Private families do not wish to take the burden of the sick. Consequently, in self-defence, hospitals are built so that any wanderer coming to a house, dying, or suffering from any disease, may immediately be packed off to a hospital and not become a burden upon private charity. The fact that many diseases are contagious rendered hospitals necessary for the preservation of the lives of the citizens. ”

“ Most people assume that the older generations did not know how to build good hospitals. They did as well as they could, but until the development of modern knowledge of hygiene and sanitation, as well as the demand made on hospital administration by modern surgery, hospitals could scarcely be expected to be anything but the sordid piles of buildings they usually were, thought proper if they but furnished a protection from the weather and sustenance for the sick poor. ”

“ No effort will be spared to render the very best service possible under the circumstances and conditions imposed.
Just what the future will hold for the Public Health Service in this work, it is now impossible to say. It appears, however, that the Public Health Service for sometime to come will be one of the designated agencies for furnishing hospital care and treatment to beneficiaries of the U. S. Veterans’ Bureau. This responsibility of supplying hospital facilities, with all that is implied, will be as adequately met as possible. ”

“ Often, too, these diseases rose to the height of epidemic pestilences, so that patients, however extreme their need, dreaded the very name of hospital, and the most skilful surgeons distrusted their own craft. New hospitals or new wards were built, yet after a very short time the new became as pestiferous as the old; and even scrupulous care in ventilation and housemaids’ cleanliness failed to prevent the devastation. Surgery had enlarged its freedom, but only to find the weight of its new responsibilities more than it could bear. ”

“ If we close the ward to visitors ... we have never in all the years the hospital has been in existence done ... that! Public confidence is our greatest asset. Has been. What shall we do? The newspapers, the police, the reputation of the hospital, d’y’see?”
“Too well, sir.”
But the tension was wearing itself out in speech and Dr. MacArthur went on:
“The hysteria among the nursing and medical staffs was bad enough, God knows, but before today is over, we must face the hysteria manifesting itself among the menial staff. How can a hospital run without orderlies, electricians, cooks? ”

“ Before the move was made to Spearman's Farm the Hospital was enlarged, and the staff was increased by the addition of eight civil surgeons. It is sad to report that of these two died in the camp and others were invalided. No men could have worked better together than did the army surgeons and their civilian colleagues.
The greatest capacity of the Hospital was reached after the battle of Spion Kop, when we had in our tents about 800 wounded.
Some account of the nurses who accompanied the Hospital is given in a section which follows. ”

“ Patients’ cottages have electric call bells to summon the nurse, and electric lights are supplied from the City Hospital plant. A bath house is now being erected, providing separate bath rooms for male and female patients.
Adjoining the City Hospital grounds the Flower Mission—a private charity partially supported by public funds—maintains a hospital for incurables. It is the only place in the State where hopeless cases are received. The Flower Mission nurses also minister to the relief of tuberculosis patients at their homes. ”

“ The buildings constituting the Hospital are two fine large airy edifices constructed of white marble, with galleries and piazzas, and surrounded by well-kept grounds which abound with choice fruit trees, and every requisite for the health and comfort of the invalids. The patients remain there only while under treatment for disease. ”

“ The chief nurses have stated that the care of the patients means only “more patients.” There is no special problem in dealing with them and under the above conditions, they accept the necessary discipline and restriction which are fundamental if hospital treatment is to succeed.
It would seem, therefore, that the problem, as has already been pointed out, exists chiefly in the U. S. Public Health Hospitals where the greater number of patients from the Veterans’ Bureau are receiving care and treatment. ”

“ The company erected at a cost of more than $60,000 a thoroughly modern brick hospital of thirty-five bed capacity which furnishes absolutely free to its employees and their dependents every type of medical, surgical and obstetric 78 treatment. No charge is made for any hospital care, operating fees, or for medicines. ”

“ The accommodations are excellent, the attention the best. Those who are able to pay are required to do so. At the water’s edge, on the eastern side of this hospital, are several wooden buildings designed for the treatment of patients suffering from typhus and ship fever. These will accommodate one hundred patients, though the number is often greater.
Immediately in the rear of the Small-pox Hospital, though far enough from it to be removed from danger, is the Charity Hospital, a magnificent structure of gray granite, said to be the largest hospital in America. ”

“ It is easily seen from such a description of a modern operation that no case can receive due care in one of our modern homes, even the best. The facilities do not exist, and hence surgeons are more and more declining to do operations, whether for accident or disease, in private houses, except in a case of absolute necessity, and a happy custom is growing more and more in favor with the community of having all operations and all accidents cared for in a well-equipped hospital. ”

“ The character of cases treated and the nature of operations performed embrace all the variety of diseases to which women are peculiarly liable, and for the treatment of which this institution was established.
The general health of the hospital has been remarkably good, not a single death occurring among the patients admitted during the year. ”