open to the air. A pavilion never should be more than three stories high; and where ground is easily obtainable, it should be only one story high. The pavilions where there are more than one story should be separated from one another by a space equal at least to twice their height. In general hospitals the pavilions for medical, surgical, and contagious diseases, should be separate buildings. The smallest general hospital, therefore, should consist of at least three blocks of wards, each block being but one story high. The administrative department likewise should have a block to itself, containing board-room and apartments for the resident officers, etc. In addition to the large wards, each hospital should have several small wards for the accommodation of cases requiring isolation. The plan of supplying hospital accommodation for villages by means of what are termed "Cottage Hospitals" has, within the last few years, met with great success in many villages in England.

The general principles to be followed are the same as for larger buildings, but they should seldom be constructed for more than a dozen patients; the wards should be miniature pavilions, and may be combined in any number according to the circumstances of the village. Cottage hospitals are specially applicable to a country like Ireland, where there are many small towns and villages remote from workhouse hospitals or county infirmaries.

Epidemic Hospitals.-These are intended for use in times. of epidemics, and may at other times be used for the treatment of contagious diseases.

It has been too much the practice to provide for epidemics by the erection of temporary buildings; this is an objectionable practice, not only from the buildings being temporary, but because their construction is usually not commenced until the epidemic has established itself, and the disease has spread more quickly than the hospital accommodation can be provided to meet it. This has unfortunately been exemplified in almost every epidemic which has visited Ireland.

Every Sanitary Authority should provide an epidemic hospital for its district, the accommodation in it being equal to that of an ordinary hospital; that is, one hospital bed for

every 200 people in town, and one for every 400 in country districts.

Intercepting Hospitals.-Port sanitary authorities are bound to provide hospitals for the reception of persons labouring under contagious diseases who may arrive in ships from infected ports. These hospitals may be either floating or situated on land in an isolated spot near the port-the latter is preferable. There will almost always be some suitable piece of land for the building of a port hospital, and extensive powers are given under the Public Health (Ireland) Act, 1874, for acquiring such sites. Floating port hospitals may be either built specially, as is the case in the port of Dublin, or a ship may be fitted up for the purpose.1

When a floating hospital, however, is employed, special arrangements should be made for the conveyance of the sick to the hospital from the infected vessel. A bed, capable of being swung from the ship to the boat, and again lifted into the hospital ship and lowered at once into the ward, through a hatchway, should be provided in connexion with each port hospital.

Convalescent Homes.-Accommodation should be provided for convalescents from all forms of disease, but specially for those who have suffered from contagious zymotics. Convalescent hospitals are advantageous and necessary in many ways; they aid in restoring health to the patients, rendering them able to return at once to their employment, thus preventing their future ill health and its resulting pauperism. Nothing tends so much to promote chronic disease as returning too soon to ordinary work after an acute illness. In contagious cases it is most important to retain patients in a convalescent hospital for some time after the subsidence of

1 Floating hospitals are objectionable on many grounds. The motion of the vessel in stormy weather, even in the most sheltered spots, is calculated to injure the patients and render communication with, and removal of, patients to and from the hospital difficult; and it is more difficult to carry out sanitary arrangements on sea than on land.

the disease, as a preventive measure and for the safety of the public; for many epidemics, such as small-pox and scarlatina, are kept up by the patients leaving hospital before they are free from contagion.

Hospitals for Incurables.-These must be more of the nature of asylums for the aged and infirm than of hospitals for those who are usually looked upon as sick. In fact, hospitals for incurables can scarcely be classed among hospitals, but are necessary and valuable charities, and deserve encouragement; they should not, however, be confounded with true hospitals, which are meant for the cure of the sick.

Lying-in Hospitals.-It should be the duty of sanitary authorities to make provision for lying-in women. The general principles of construction are the same for lying-in hospitals as for others; but certain special provisions must be made in them. The patients should be delivered in a separate ward from that in which the after-management is carried out. Only one woman should be delivered at a time in the ward, so that for a large number of cases more than one delivery ward should be maintained. It is generally considered that not more than four parturient women should be permitted to remain in one ward, and many even believe that each woman should have a separate room. As the hospital should be constructed on the pavilion principle, the blocks must be small; but as the majority of lying-in cases do not require such constant watching as other cases, one head-nurse may supervise several small wards. One great advantage of small wards is that they can be easily closed for cleansing purposes, and each room be disused for a time in turn.

REFUGES FOR THOSE REMOVED FROM INFECTED DWELLINGS.

These should be provided in every town where numbers reside in one house, in order to stop the spread of an epidemic which may have broken out. The sick should at once be removed to a hospital, and the healthy to a refuge where they

T

can be watched against the outbreak of further cases, thus enabling the infected house to be cleansed and disinfected. The refuge should be arranged in sets of rooms, so that each family removed to the refuge could be kept together. This is necessary not only for the comfort of the family, but also for limiting the spread of the disease to the particular group of people among whom it originated.

QUARANTINE.

The system of placing vessels arriving from countries where contagious zymotics prevail in quarantine has been almost abandoned in this, although still in use in many foreign countries. Instead of quarantine, the system of examining those on board ships coming from infected ports, and detaining the sick in port hospitals (already referred to), and allowing the healthy to land, has been substituted. The reasons for abandoning quarantine are, that the results obtained by this method were not commensurate with the trouble and loss inflicted on the individuals detained, and the interference with trade. The loss and inconvenience arising from quarantine were so great that there was great inducement to avoid it, and thus many diseases were introduced in a contraband way. Few, however, object to the system of inspection and removal of the sick, so that the inspection system, though less stringent in its rules and less annoying to those concerned, is likely to prove more efficient than the old quarantine system. The International Sanitary Congress, held at Vienna, July, 1874, decided that "land quarantine is impracticable, useless, and injurious to the interests of commerce, and should not be enforced." Although there was some difference of opinion among the members of the congress as to whether quarantine should be enforced in its full sense, yet the congress ultimately arrived at the conclusion that the inspection system, accompanied by efficient disinfection, might be substituted for it.

1

1 London Medical Record. August, 1874.

CHAPTER XXV.

METEOROLOGY AND CLIMATE.

MODERN METEOROLOGY-Buys Ballot's Law-Meaning of Terms "Cyclonic" and "Anticyclonic"-Continuous Registration of Weather Phenomena-Weather Telegraphy. CLIMATE, Defined-Conditions on which its Characters Depend-Winter and Summer Climates of the Northern Hemisphere Winter and Summer Climates of the British Islands. Local Climates-Depend on (1.) Configuration of Surface; (2.) Vegetation; (3.) Soil; (4.) Presence of Water. Diseases connected with Presence of Water in the Soil.

METEOROLOGY, in by-gone days, was limited in its application to appearances in the sky, whether atmospherical or astronomical in their character; and this was in strict accordance with the etymology of the word.1 At the present day, however, the word is used in a much more extended sense, to denote a branch of natural philosophy which deals with weather and climate; its astronomical connexions are, to a great degree, severed, while many terrestrial phenomena are included within its vast domain, and are studied and explained under some of its many branches.

So recently as twenty years ago very little was known as to the dependence of the direction and force of the wind on barometrical and thermometrical conditions-at least outside the tropics. But in 1854, the Rev. Dr. Lloyd, the present distinguished Provost of Trinity College, Dublin, demonstrated the cyclonic character of most of the gales experienced in Ireland, and so foreshadowed what is now universally

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1 Τὰ μετέωρα "Things in the air," "natural phenomena,' heavenly bodies "-Cicero's " Supera atque cœlestia."-(Liddell and Scott.)

2 Notes on the Meteorology of Ireland. Royal Irish Academy Transactions. Vol. xxii. Science. 1854.