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toration of the reason and of the power of disputation, especially if it be sudden, is of no very favourable augury in the absence of a return of the natural sensibility. Integrity of the emotive sense, indeed, is the circumstance upon which practically medical men who have the charge of the insane always rely with the greatest confidence in the matter of prognosis."-p. 228. In the seventh chapter, causes and physical treatment are discussed. In reference to the former, the author restricts the term physical to circumstances of mechanical violence done to the head, and divides all other exciting causes into physiological and moral. To this it may be objected, that strictly speaking all causes are physiological. The old binary division of causes into physical and moral is more simple and convenient than this ternary one, and does not suggest the error that any causes are not physiolo

especially judicious; we apprehend, however, that the concurrent existence of these maladies is not uncommon and occasionally constitutes one of the most troublesome forms of disease with which the physician has to deal. The fourth chapter is on the varieties and particular characteristics of insanity. The good sense of the following will be readily admitted. “A division and classification resting upon permanent differences and exact definitions I believe to be impracticable to any extent. We may abstract and arrange particular phenomena, so as to bring them more distinctly under recognition; but when we investigate them in their concrete realities, the very best schemes are found to be imperfect and unsatisfactory. All writers and statistical records have their cases of mania, melancholia, dementia; and other familiar terms are constantly employed. These, however, do but exhibit the more salient groups of the pa-gical. In the enumerations of causes, disorders of the thological picture; and in many instances they have uterine functions are omitted. The influence of molittle more fixedness than so many dissolving views. dern civilization in producing "perpetual craving after For a case of melancholia may become one of mania, moral and mental excitement,” is truly and graphically and conversely mania may become melancholia; or depicted. The author concludes: "We strive systemthe two affections may be present simultaneously. atically and habitually to procure gratification to the Again, mania may degenerate into dementia; or cha- | emotive sensibility, and the result but too often is racteristics of the two states may display themselves at mental irritation, and dissipation of our fondest illuthe same time. Insanity is not unfrequently a periodic malady, and at each of its returns the ailment may assume new phases. An ordinary case, indeed, may in its progress take on numerous and very different forms."-p. 124.

Mr. Noble advocates what he considers to be a new classification of the phenomena of insanity, based upon his new cerebral physiology. In this, however, he is mistaken. Dr. Arnold, of Leicester, who wrote in 1782, adopted a classification very similar to Mr. Noble's. Mr. Noble divides insanity into three classes, Intellegential, notional, and emotional. Dr. Arnold divided it into two classes: Ideal, and Notional; making Emotional a species of the latter class under the term of Pathetic insanity. Had Mr. Noble's classification really possessed the charm of novelty, we should still have objected to it, on the ground that it was better to retain the old arbitrary terms which have long been made to designate the concrete realities of insanity, notwithstanding their etymology may be traceable to erroneous opinions; rather than prematurely commit ourselves to a new set of terms, involving other opinions which may prove equally erroneous. No attempt is made to alter the name of afferent blood vessels, although the term artery arose from a misconception, at least as great as the most objectionable of the old lunacy terms; and mania, melancholia, lunacy, and the like, are become good sterling words, conveying a clear sense of the things they represent. Pray let us avoid neologizing insanity, at least until we can obtain a physiology for the work “something more than rationally hypothetical," which is the avowed basis of Mr. Noble's classification.

sions. In this state of things it will readily be conceived, that in a large proportion of cases, the commencement of insanity is attended with a painful state of the feelings and the affections. Melancholy, indeed, ushers in numerous instances, which in their progress assume other characteristics. The operation of the exciting cause when moral, is very generally upon the emotive sense in the first place, rather than upon the ideas which become perverted subsequently. Nevertheless, excessive exertion of the intellectual faculties very often produces a prejudicial strain upon the cerebral tissue, and may directly occasion derangement of the intelligence, displaying itself particularly in foolish theories, and in marked enfeeblement of the higher mental faculties."—p. 254.

The remarks on physical treatment are general, and, for the most part, judicious. Few remarks on particular remedies are hazarded. The following passage sums up the physical treatment of insanity from mechanical violence: “Be constantly on the watch for physical indications, and act accordingly; but do not expect to remedy the mental aberration by bleeding, counter-irritation, purgatives, or mercurials, excepting in so far as the psychical affection may be associated with or dependent upon well-understood pathological conditions, which active treatment may be likely to remove. Let these conditions, however, be sufficiently obvious and irrespective of the mere wanderings of intellect."-p. 278.

The confused idea of a distinction between psychical and physiological affections, forms a great demerit running throughout the book; it even makes a jumble of the remarks on physical treatment. Thus, "regardThe chapter on diagnosis, prognosis, and etiology, ing the physical mischief with which in particular is judiciously and carefully written. The following instances the mental malady may be associated, the paragraph deserves notice, since the author does not therapeutical principles are very much the same as generally attribute that paramount importance to the those which guide our practise in corresponding states state of the emotions which we believe they merit. unconnected with insanity: the entire aim of physical "It is a conclusion of experience, that a partial res- treatment being in fact to reduce the cases as much as

possible to those of purely psychical disorder." The taken opinions which are peculiar and unproved, for extraordinary uses to which we put these new words such as are primary and essential. Moreover we do not compounded of psyche, make one desire the re-in- agree with him in the belief, that good introductory statement of the older terms, which would not lend works on insanity are wanting in English medical themselves freely to be woven into such absurdities. literature. The works of Dr. Pritchard alone are Substitute in the above passage the term mental dis-sufficient to refute such an assertion. His essays in ease or disorder of the soul, for psychical disorder, Tweedie's Library of Medicine, and the Cyclopædia of and it becomes absurd. Psyche makes it all smooth, Practical Medicine, are models of concise elementary but if Eros could return to earth, with what disgust teaching; and his admirable Treatise on Insanity is I would he witness the common purposes to which built up from the principles of the science, is therefore his ethereal darling is every day submitted! She strictly elementary, and forms a text book for the has become an apothecary's drab. student of mental disease, the excellence of which Mr. Noble or any other writer will find it exceedingly difficult to surpass.

The chapter on moral management is the worst in the book, and displays an amount of ignorance on this subject truly surprising in the latest writer on the treatment of insanity. The superintendents of asylums will smile to learn that, "In establishments properly constructed, there are padded rooms so adapted, that lunatics when in them cannot do themselves any harm; particularly if the hands be gently secured in muffs, or in cases of great severity, if the arms be carefully placed in appropriately fashioned sleeves."—p. 227. So that padded rooms are not to supersede mechanical restraint in the worst cases, but to be employed as an additional security.

As for the gentleness and the carefulness with which those exploded abominations muffs and sleeves are to be used, the words suggest the direction of that "quaint old cruel coxcomb" Isaac Walton, to put a worm on the hook "tenderly, as if you loved it." Where has Mr. Noble observed this application of moral management? Certainly not at Cheadle or Prestwich, and scarcely, we should think, in the private asylum to which he is visiting surgeon. Seriously let us assure him, that at the present day the only muffs to be found in county asylums at least, (and even such are rare and very seldom resident,) are endowed with life and feeling, and are therefore infinitely preferable to those inanimate instruments of torture, whose gentle use is recommended, but which, we trusted, had by this time begun to acquire value in the eyes of archeologists and collectors of curiosities.

History and Description of the Kent Asylum, by J. E. HUXLEY, M.D., the Medical Officer and Superintendent.

The Kent Asylum is placed on Barming Heath, within two miles of Maidstone, the county town, and about six miles north-west of the centre of the county. Its site is elevated to from 200 to 300 feet above the level of the river Medway, by a gradual ascent from the town; and the building stands on the top of a line of hill overlooking a valley, in the bottom of which lies that river. The surrounding district has been called the garden of Kent; being a part of the county most largely producing hops, vegetables and fruits. For a great part, this is a highly cultivated area; and where the land is not under tillage it bears woods, chiefly of oak, with a valuable undergrowth.

The aspect of the front of the asylum is nearly south, and commands a fine and varied prospect; whether the eye be directed forward, over the sides of the valley, covered with hop plantations and fruit trees; or, to the west, where the line of opposite hills gradually dips, disclosing a foreground of timbered and park-like scenery, with hill again in the far distance; or, to the east, where the view is bounded by a part of the backbone of the county, a fine range of chalk hills. This range extends for many miles north-west being at all times a fine object and, under certain conditions of light and shade, presenting the exquisite beauties of a far and gradually vanishing landscape.

In conclusion we must demur to the title which Mr. Noble has chosen for his work. Whatever may be the merits or demerits of his lectures, they most certainly do not form a systematic introduction to the science by laying down first principles for the guidance of beginOn the north and north-west are extensive woods. ners. The author observes that "the many excellent The land belonging to the asylum is nearly level, but works which already exist upon the subject, are obeying the general inclination towards the valley in a generally of too high a character for initiatory study; moderate degree, enough to render artificial drainage being for the most part contributions to our knowledge for the removal of surface water unnecessary. of the subject under particular aspects, rather than History of the site. The county surveyor, architect treatises for conveying elementary instruction." This of the buildings, has kindly furnished me with the desideratum he proposes to supply in the present work, following particulars. "The first and principal portion but we are bound to say that he has entirely failed to (of land) was purchased of the parish of Maidstone, redeem the pledge contained in his preface. The at whose expense it had been brought into cultivation, book is full of the author's peculiar and very disputable a few years previous to the erection of the asylum, by opinions, but contains scarcely a modicum of rudi- the labour of the paupers. The land, previous to its mentary information. To call it "elements of psycho- coming into the possession of the parish, was common logical medicine" or an "introduction to the study of land, belonging to the lord of the manor of Maidstone insanity" is a glaring misnomer; and were any of the and certain tenants, who surrendered their rights to author's commercial townsmen to imitate his example the parish that paupers might be employed in profitin this respect, they would be very liable to have their able labour, during a season of great distress." This wares returned upon their hands. Mr. Noble has mis-land, together with some adjoining, which was occu

pied by cottages with gardens and fruit plantations, in all about thirty-seven acres, formed the first purchase on behalf of the Lunatic Asylum. The second and only subsequent purchase was made in 1847, and consisted of about twenty-four acres of arable land. The entire quantity now belonging to the asylum amounts to sixty acres and eighteen poles; which is thus appropriated: to buildings and airing-grounds, eight acres, two roods; grass, twenty acres, one rood; spade husbandry, nine acres, one rood, fourteen poles; under plough, twenty-two acres.

Geology.*-Barming Heath is composed of a bed of cherty ragstone and red clay, termed "local drift," resting on beds of Kentish rag, a marine limestone belonging to the lower division of greensand. The surrounding neighbourhoods of Cox-heath, Kingswood, Mallingwoods, are of the same constitution. The soil is what is called poor, cold and hungry. The thickness of the surface soil or local drift may be about eight to twelve feet; the thickness of the Kentish rag-beds is very variable. Below these we find the Atherfield clay, resting on the Weald clay and Hastings sand. Water permeating through the above strata is generally hard, from the quantity of carbonate of lime which it gets in its passage to the Atherfield clay.

to a large cistern placed on the top of the central house, and, therefore, sufficiently elevated to feed all other cisterns in the roofs of the wings. The general sewage was conducted by drains to large cess-pools distant from the building on the falling side of the ground. Rain water was collected in tanks for the use of the steam boilers and other purposes.

These arrangements all remain the same, but have undergone, in the course of twenty years, a three-fold extension. The airing grounds, which were of moderate size, were placed back and front.

Both in respect of the building and of the airing grounds the south aspect has always appeared to me ill-chosen, since one side, alone, receives the whole day's sun. The situation being, from its elevation, without shelter, the front is scorched in summer all day long; and in winter, the back airing grounds are often damp and cheerless, for want of the rays which they might have shared with the front, had that received a south-east aspect.

Before three years had elapsed, the space had become insufficient for the demand, and the medical officers recommended the erection of detached noisy wards and of small hospitals. It was finally determined that hospitals were, and noisy wards were not necessary; the erection of two small hospitals, each for six patients, was consequently ordered. Two years later, these hospitals were enlarged by the addition to each of seven beds. This was in 1837. In three years more, it had become necessary to build again, and in the course of the next two years, additional space was completed for one hundred patients. This comprised two wings, one for each sex, which were built adjoining the old returned wings at their northern ends, at a right angle with them, and having in front a south aspect. In 1844-5 another wing, on the same line was added for women, and the hospital for that sex removed and enlarged; and in 1846-7, a corresponding wing for men, with a similar change in the situation and size of their hospital. This completed the older asylum, which consists of twenty-four wards and two hospitals, capable of containing four hundred and forty-three patients.

Origin and form of the building.-In the autumn of 1828, a committee was appointed to superintend the erection of a lunatic asylum. After due enquiry, an open and elevated site was chosen, and plans were ordered to be prepared for a building to accommodate one hundred and fifty patients. In the course of the preparation of these plans, the surveyor was desired to confer with Mr. Sylvester, C.E., upon the introduction of warmed air into the building, and to report thereon. The purchase of about thirty-seven acres of land was concluded, the plans, comprising arrangements for warming and ventilating, were approved, and the work was begun. The asylum, being finished, was opened for the reception of patients on January 1st, 1833. It appears that the actual accommodation was for one hundred and sixty-eight patients. The form of the first building was very simple, consisting of a central house of four floors and two wings, or tiers of wards, of three floors, on each side. The house and front wings right and left, face nearly south, the remaining wing on each side being returned at a right angle ex-house and eight wards for two hundred and eight tending backwards, and consequently facing, on one side east, on the other west. The offices are in the centre, behind the house. The entire form was that of the letter E. with its principal stroke looking to the south. The style of architecture is quite plain, but of a somewhat imposing solidity; the walls being of plain coursed masonry, having two string-courses of picked stone, with a handsome, massive cornice and parapet surmounting them and half concealing the slated roof. All quoins are of dressed stone. The material used is the ragstone which is very plentiful in the vicinity. Thus, the first building consisted of a house and offices and twelve wards, of the average number of fourteen beds in each. Water was raised by a steam-engine, from a well about one hundred and twenty feet deep,

In 1850, a new detached building, erected at a short distance north-east of the other, consisting of a central

patients, was opened, making the whole establishment capable of receiving six hundred and fifty-one patients. In the three years subsequent, that additional asylum has been fully tenanted, and we have, now, about one hundred vacancies, which are apportioned to the discrepant wants of the two sexes.

In 1846, I found the hospitals empty and rarely used, and proposed their conversion into noisy wards. Without denying the limited advantage of hospitals, or infirmaries, to an asylum, it seemed to me that these buildings might be put to another and much more important use. They were fitted up as noisy wards, and have been so used ever since.

The first idea under which the additional asylum was projected was that of making it a chronic asylum, in the terms of the 8 and 9 Vic. 126, sec. 27. That

*I am indebted to my friend Dr. Plomley, of Maidstone, for design, however, was soon abandoned; and it was this geological statement.

determined to reserve it for chronic patients free from

dangerous or offensive habits, and, also, for curable | water-closets are, without exception, self-acting. That and convalescent patients, whom it might benefit to is, the regular introduction of water into the pan, on transfer, during progress, to a quieter situation with each use, is effected through the movement of the fewer restrictions and a more select companionship. door, in the passage of a person in and out. In Agreeably with this design, a variety of mere safe- passing in, the action begins; water flowing, in a guards were omitted in the building, with the generally known and full quantity, into a compartment of the pervading intention of avoiding, as much as possible, cistern; from which it descends into the pan when the restrictions both in appearance and fact. The bedroom door, which can then only be pushed outwards, gives windows were, therefore, made large, and placed low egress to the occupant. The value of this arrangeenough for a person standing, to look out of them; ment greatly consists in the circumstance, that the and no window-guard, whatever, was applied. The very brief movement of the door in entering is made bedroom doors were all fitted with spring-locks, having long enough to place the requisite quantity of water a brass handle outside only. By this, it was intended for the next discharge in the compartment; whilst to dispense with the use and sound of the key in lock- the corresponding movement of the door, in leaving, ing up. The door being pulled-to, and having no is enough to secure the descent of the whole. Perhaps inside handle, would be as effectually fastened on the the great practical advantage of the mechanism is that, tenant of the room as if secured in another way; and, from its simplicity, it scarcely ever gets out of order, although the fact of locking remains, and the change and, I might say, never from any other cause than the may seem to amount to no more than a distinction unfailing effect of time, and the natural destruction of without a difference, the unpleasantly suggestive noise materials. made by using a key is rendered unnecessary. The whole interior is very light and airy. There are no stone floors. The bedsteads are wholly of iron. The common, full sized, steel knives and forks are used in all the wards. Outside, the airing ground walls are sunk four feet in a ha-ha, and rise four feet above the common surface, whereby the prospect is nowhere intercepted by them.

Internal arrangement.—Except in he two noisy wards, there are no day-rooms in these asylums, in the strict meaning of the term. The day apartments are galleries; varying, of 10 feet by 96 feet, 15 feet by 72 feet, 16 feet by 45 feet, and 18 feet by 65 feet in size; every story being of twelve feet from floor to floor. On one side of each of these galleries, are the bedrooms, communicating directly; which circumstance, I presume, disentitles them from receiving the name 'day-rooms.'


The baths are supplied with hot water, from cylindrical reservoirs of from three hundred to four hundred gallons each, situated in the roof over each tier of three baths; and the sinks draw their supply from the same sources. Cold water for both these is derived from small cisterns, similarly placed, which are themselves supplied by the principal cistern, on a higher level in the roof-chamber of the central house, before described. The water in the cylinders is heated by a circulation of other water, by which it is surrounded as by a jacket, between them and boilers in the stokeries below. Warm baths may be had at any time, night or day, for the mass of water in the cylinders can cool but very slowly, as it is cased in sawdust and wood; nor is the quantity obtainable, at any one time, for bathing a number of persons, limited by the capacity of these cylinders. This is accomplished as follows. The supply of cold water to the cylinders, being from a higher With few exceptions, they are exceedingly light and situation, is allowed to enter them at their lowest point. airy, having four, five, or seven large windows in the On the other hand, the hot water is drawn from them front or southern sides, with end lights, in addition, at their highest point, as if by an overflow. Thus, the in one half the number. An attendant's room is hottest or uppermost water is drawn for use, whilst its placed at the junction of every two wards (in the older quantity is simultaneously replaced by cold water, asylum); and, so far as regards the three tiers next entering at the bottom, which immediately receives the centre, the attendants have access from their heat. It is evident that no hot water could be drawn rooms, right and left, to two wards each, and through if the supply of cold were turned off, though the their half-glazed doors a two-fold means of observation cylinder be itself quite full; and that the cylinder also. The proportion of single and associated bed- cannot be emptied, and thus have its joints exposed to rooms is three hundred and fifty-one single, to fifty-injury. The baths, themselves, are all built of brick, seven of the latter. These vary in containing from two of a full size, and are lined with square, glazed, whiteto twelve beds each, and average five and quarter beds. ware tiles, embedded in cement. The whole is finished Every ward has its own water-closet and little scullery with a flat broad wooden top. The place of entry of with sink; and there is an excellent bath for the joint water, both hot and cold, is the centre of the bottom; use of every two wards on the same floor. The sinks, and the discharge, or waste, is through the same aperwhich are all bell-trapped, have a liberal supply of hot ture, very simply closed and trapped. as well as cold water. In the recently-built, detached The bedrooms for a single patient each, are, for the asylum there is also a lavatory in each ward, fitted up most part, seven feet by ten feet in size; in the older with white-ware basins fixed in slabs of slate, which wards rather larger, and in the most recent rather are fastened to the walls. Each of these basins has smaller. The windows, throughout the principal asycold water supplied by a tap; and a discharge pipe, lum, are seven feet from the floor. In size they vary with strainer and tap, attached to the bottom. A from 3 feet 3 inches by 2 feet 8 inches, to 2 feet 8 general supply of hot water is near at hand. In the inches by 2 feet 2 inches. In the detached asylum, older parts of the asylum, distinct lavatory convenience they are of the uniform size of 3 feet 2 inches by 3 has been supplied where the opportunity offered. The feet 4 inches, and placed only 5 feet above the floor.

jury is generally limited to a single panel, which can be easily removed, mended and replaced.

In eighteen out of the thirty-four wards, the entire floors are of stone or slate. In the rest they are wholly of wood. In eight wards, on the ground floor, many rooms of which have been, within a year or two, repaved with slate, every single sleeping room has, in its centre, a bell trapped drain, to which every part is made equally to fall. So long as it may be deemed necessary to use for flooring, any material of a stony nature, slate deserves to be highly esteemed for the purpose, since nothing can be more easily and thoroughly cleaned. It appears to be absolutely free from the capacity to absorb and, when once cleansed, it cannot contribute any impurity to the air of a room. Another advantage of slate is, that a floor may be laid in four pieces, in order to have as few joints and interstices as possible. The slate should always be rubbed to a fine face, which it bears well, so as to allow of no little cavities for the lodgement of impurities. Before slate was thus used in this asylum, three kinds of material, of which this was one, were submitted to experiment. Three floors were laid with sheet gutta percha three-six

In the earlier building, they are generally covered by | and top rails, and the whole are fixed close, side by guards of wire, crossed in a fine mesh, in oak frames. side, by the last panel, which is screwed. Thus, inBut some wards in the older, and all in the newer asylum are devoid of any protection whatever. The universal size of the paues of glass, both here and in the gallery windows, is 10 inches by 7 inches. The frames are, in every case, of cast iron. They are made to open in three different ways; the newest, only is deserving of description. In this kind, the upper row of panes is contained in a double or second frame, which is hinged along the top; to be held open, like a pent roof, by a notched arm which works through a hole, just below the moveable portion, and, when that is closed, falls down with an elbow-joint, and is screwed, lower down, into the middle style of the frame. This form of window is particulary good for an asylum which is artificially ventilated; as from its more perfect closure and impediment to leakage of air, adverse draughts of cold air do not interfere with the prescribed movement of the inner air, by the appointed flues. This circumstance may seem of little importance; it is necessary, however, as well as consistent, under a system of artificial ventilation, to keep that free from too much disturbance by accidental window currents. Just as it is necessary to the maintenance of the whole force of a steam-engine, to prevent the irregular es-teenths of an inch thick, with tiles of Wedgewood ware, cape of steam from the cylinder. The door-jambs are nearly all of cast-iron. Bed-natural contraction, which I have also observed in other room doors all open inwards; the advantages of which, over the opposite plan, are manifest. In the older building, they are all fitted with inspection plates of the old fashion, viz: a small plate of iron moving sideways on a pin, disclosing a round hole, about an inch in diameter, in a cast-iron funnel, covered by the plate, which may be fixed with a screw. It may be remarked that a tenth part of these inspection plates would suffice, their real utility being very limited.

Another appendage to some doors, in the noisy wards, is a small commode with enclosed copper pan, strongly attached, seat high, to the inside, for the purpose of encouraging cleanliness in some patients when in too violent a state to be entrusted with any loose vessel, or article of weight whatever. It is also a safeguard to an attendant going in, and avoids giving the means of making a great noise, by withholding an instrument for beating the door. There are four well-padded rooms; that number being amply sufficient for cases really requiring them. I apprehend that a padded room is never strictly necessary, except for a patient suffering from a certain delirium (particularly that kind attending epilepsy) rendering him reckless, or insensible to self-injury; or, for one who would beat his head against a wall or other hard object, as the only means left for self-destruction; or, in certain states of acute mania, far advanced, and undergoing rapid exhaustion, where the sufferer, however seemingly reduced, still finds the power, at intervals, to make efforts at action which result in bruises and personal injury; for the instinctive avoidance of which there is neither care nor energy left. Two of these rooms are better constructed than the rest. They are padded in panels, 8 feet high by 2 feet wide. These are all moveable, but held in their places by studs fixed to them, which fit into bottom

and with slate. The gutta percha proved subject to a

situations of its use, which gradually drew out its edges from beneath the skirting of cement which had held it down on the floor. The wedgewood tiles, from their small size, had a great quantity of joints, and formed when laid a very imperfect level. The choice, therefore, fell upon slate, which offered every advantage except that of the lower heat-conducting power of the gutta percha. The slate was the cheapest and gutta percha very costly.

Ventilating and warming.—I now approach what, in my humble judgment, is a very important subject; and am, therefore, desirous of making a clear exposition of the principles and substantial means by which the above processes are effected in this asylum; not because I deem the means perfect, subject as I have for years seen them to alterations consistent with the march of improvement in the science and art; but, because the example in this respect, so long shown here, may have a valuable interest for all those in authority over other public asylums; than which no class of institutions can possibly be found, more to need and benefit by, an efficient use of these agencies. I allude, chiefly, to asylums yet to be built, for I am induced to think it would be found little fruitful to attempt to apply to an existing asylum, a thorough system of ventilation.

There are two grand reasons, I know not which to consider the more important, why an asylum should be artificially warmed and ventilated. First, there is no other way by which the bed, as well as the day apartments can be kept in a state of warmth suitable to the medical requirement of many insane persons; and, second, there would appear to be no other way in which a large majority of the patients can be saved the necessity of breathing, all the night, either a stagnant and impure, or, a highly vitiated and offensive atmosphere.

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