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I 
AN
ADDRESS
DELIVERED on the
OCCASION OF  THE INAUGURATION
NEW  SOUTH  BUILDING
NEW  YORK  HOSPITAL,
ON THE 18TH OF APRIL, 18.».
  BY JOSEPH  M.  SMITH,  M. D.,

SENIOR PHYSICIAN OF THE NEW-YORK'HOSPITAL ;  PROFESSOR
  THE THEORY AND PRACTICE OF PHYSIC AND  CLINICAL
     MEDICINE IN THE NEW-YORK COLLEGE OF
         PHYSICIANS AND SURGEONS,
             &C, &C.
a 3 3 <fc;
            NEW-YORK :
T. CALLAHAN & CO., PRINTERS, 113 NASSAU STREET
1855. 
I8L5
PUBLISHED BY REQUEST  OF THE



      BOARD OF GOVERNORS. 
ADDRESS.
Gentlemen :

        The institution and multiplication of Hos-
pitals are among the most striking  evidences of
the progress  of civilization, and of the benevolent
and noble spirit of those engaged in their support
and management.  Their origin is distinctly trace-
able to the enlightening and humanizing influences
of Christianity.  Among the  ancient Greeks and
Romans hospitals were unknown.  The poor were
allowed to suffer and die  under such  shelters as
might fall  in  their wajr.  The wounded in battle
had no  retreat where they could  collectively re-
ceive medical care.   The temples were the only
places  where  the  sick  congregated, not  for the
purpose of admission  as resident patients,  but for
the purpose of obtaining a knowledge of the rem-
edies which were there recorded as  having been
curative in cases similar to their  own. 
4
   In their general character, as sources of medi-
cal relief, the  temples of heathen antiquity were
more nearly allied to modern dispensaries than to
hospitals.  It  is said by  a  distinguished medical
scholar, Professor Bartlett, in his " Discourse on
the-Times, Character, and Writings  of Hippocra-
tes," that  " The sick who visited the temples for
relief, were subjected, under religious forms, to a
preparatory regimen, consisting of prolonged  ab-
stinence, or a rigorous diet,  and variou*s purifying
ablutions and inunctions of the body.  After these
preliminaries,  a night was passed in the temples,
and the  patients subjected  to  the treatment  or-
dered by the Asclepiades.  A certain number of
the patients who had been cured, left in the  tem-
ples votive tablets,  grateful  offerings to the gods,
containing brief records of their diseases and their
cure.   Strabo  says,  ' the Temple of Epidaurus is
always full of the sick, and of the tablets on which
the treatment  is inscribed ;  and it is the same at
Cos, and at Tricca." "
  The  epoch of the institution of hospitals is usu-
ally referred to the  sixth century, or the reign
of Justinian.   They seem to have been for a long
time connected with monasteries, and  under  the
direction of those in whom were united the medi-
cal and clerical characters.  But the greater num-
ber of  infirmaries have arisen since the Reforma-
tion ; and in many instances, the edifices now used 
5
as hospitals were  formerly conventual  establish-
ments.   Hundreds of years elapsed before institu-
tions were founded for the special and exclusive
benefit of the  sick and  poor.   Indeed, as matter
of history, hospitals scarcely deserve to be  men-
tioned before the twelfth century, in  which age
St. Bartholomew's, in London, was  founded by
Henry I., though subsequently endowed by Henry
VTII., and rebuilt  in the reign  of George II.  Of
the few of any note  established in  the  fifteenth
century was Trinity Hospital, a small  institution
at Edinburgh.  After  this period the  number rap-
idly increased.   Among those  which  sprang  up as
general or special infirmaries, and  which are the
most celebrated and best known to us, in the six-
teenth century, were  St. Thomas' of  London, and
the enlargement of the Hotel Dieu at Paris, one
of the oldest in Europe, dating back  as far as the
seventh century ; in the seventeeth century, were
the  Bethlehem, St. Louis, La  Pitie', La Charite,
La Salpetriere : in the eighteenth  century, St.
George's, the  London,  Guy's,  Middlesex,  Lock,
St. Luke's, Royal Infirmary  of Edinburgh, Des
Enfans Malades, and Des Yeneriens.  There were
also many  others founded in  metropolitan,  pro-
vincial and colonial situations ; and  among  these
last was  one in the colony and city of Xew York.
In the present century infirmaries have  so multi-
plied, that there are few places, especially in mar- 
6
 itime countries, having a city population, in which
 there is not one or mt>re established with charter-
 ed rights, or under the management of a munici-
• pal government.
   Of the history of the New  York  Hospital, the
 institution to which  I have just  alluded, and to
 which your attention is now invited, it is sufficient
 to say, that its charter was granted by the Earl of
 Dunmore, on the 13th of June, 1771 ; that its site
 was purchased in  1773,  and the building com-
 menced in July of the same year • that before its
 completion, in 1775,  it took fire and  was nearly
 destroyed.  The rebuilding was prevented by the
 occurrence of the American Revolution.  It was
 occupied, however, during the war, as barracks by
 British and Hessian troops,  and part of the time
 as a  hospital.   After the Revolution, it was re-
 established'by  the liberality of the State and  pri-
 vate munificence ; but it was  not in a condition
 to be used as a hospital until the 3d of January,
 1791, on which day, eighteen patients were admit-
 ted.  There being no suitable accommodations in
 the building for lunatics, a new  edifice, to receive
 that class of patients, was erected, in 1806, on the
 spot  occupied  by this  house, and was used for
 that purpose until  1821, when the Bloomingdale
 Asylum for the Insane was  completed,—that ex-
 tensive and magnificent branch of the  Hospital of
 which the institution is so justly proud.  In 1825 
7
the old edifice for lunatics was so altered as to fit
it for the reception of patients suffering from  or-
dinary diseases, and  being appropriated  to sea-
men, was denominated the "Marine Department."
In 1829, the main building was improved by  the
extension of its wings.  In 1841, the north build-
ing was erected f' and in 1850 the interior of  the
main building was entirely, or for the most part,
remodeled,  its apartments  enlarged, and many
valuable  improvements  introduced.  Lastly, in
1853, the building of the marine department was
demolished ; and in its place  has arisen  the new
Mid imposing edifice in which we  are assembled ;
a\d which we  now, on  this  18th  day  of April,
1855,  dedicate to the humane purposes of this
great corporate establishment.  And here I feel
assured, that this enlightened auditory  will  unite
with me in saying to the  committee under whose
immediate  direction the building was erected,
namely,  Messrs. William M.  Halsted,  John  A.
Stevens, George T. Trimble,  Benjamin  L. Swan,
Frederick  Sheldon  and  George  Newbold, that,
whilst we congratulate them on the felicitous ter-
mination of their labors,  they cannot fail  to  re-
ceive,  for what they have so faithfully  done,  not
  * Seo Charter of the Society of the New-York Hospital, and the
Laws relating thereto, with the By-Laws and Regulations of the In-
stitution, and those of the Bloomingdale Asylum for the Insane—New
York, 1845. 
8
only the thanks of their colleagues in the Board
of Governors,  but also the applause of  those  by
whose generous donations the work was rendered
achievable:
   Of those engaged in planning and  constructing
the edifice and its appurtenances,  I  may mention
that the architect was Mr. William W. Gardner; the
masonry was supervised by Mr. Lorenzo Moses; the
carpentry by  Mr. Thomas  Gardner;  the heating
and ventilating  apparatus by Messrs.  Morris,
Tasker &  Morris ; and the arrangement of the gas
fixtures by Messrs. Dietz, Brothers <k  Co.
   The earlier European hospitals were exceeding-
ly  defective  in  their architectural construction,
their internal economy,  and their hygienic man-
agement.   Though  originating  in a spirit of be-
nevolence, they were allowed to become the re-
ceptacles of human  pollution, and the centres of
infectious pestilence.   Overcrowding, uncleanli-
ness, and want  of ventilation,  combined their
powers to destroy those who entered them as pa-
tients, or  who lived in their immediate neighbor-
hood.  We  are  told, that "the Hotel Dieu of
Paris previously to its reformation, was  the grave
of the sick poor of that  metropolis.  Hence a gen-
eral outcry was  raised against  infirmaries.   It
seemed dangerous to go near them, and the con-
clusion at one time appeared plausible  that they
ought to be abolished."   Such  a  state  of things 
9
sprang from ignorance, or a disregard of the prin-
ciples of public and private hygiene.  The danger
of overcrowding  was not  fully apprehended,  the
importance of  cleanliness  not rightly estimated,
and  the philosophy  of  ventilation  not under-
stood.   To detect the existence of these evils  in
hospitals, as well as in prisons, and to spread a
knowledge of them over the.countries of Europe,
with a view to  their  correction,  was  the  noblest
work of philanthropy in the last century,  a  work
performed by the immortal Howard.
   It has required the whole time from the period
of the origin of hospitals  to  the  present day, to
discover the principles and contrive* the means by
which the evils referred to have  been removed,
and the wards of hospitals  rendered  as  pure and
harmless as the commodious chambers of the  op-
ulent.   It would  be interesting to  trace out  the
order of the  improvements in science and  art
which  have led to this happy  result.   But  our
limits will admit  of no  enlargement on the sub-
ject, beyond a notice  of one or two of its topics.
   The mischiefs generated in the older hospitals,
and which are still liable  to  occur, were  typhus,
or, as it is called  when it originates in an infirma-
ry, hospital fever, erysipelas, hospital sore or gan-
grene, puerperal  fever and a general typhoid con-
dition of those  suffering under various forms of
disease.  In studying the sources of these evils it 
10
was discovered that they were mainly due to an in-
fectious principle or poison diffused in the atmos-
phere of hospitals.  The removal of the urine and
faeces of the patients from the apartments was not
sufficient to preserve their purity.  The chief source
of the  poison was ascertained  to  be  the emana-
tions from the lungs and skin ;  and that the mere
washing of the floors  and bedding and  clothing
was of secondary importance, compared with ven-
tilation, the first and  most essential prophylactic
of the maladies originating in hospitals.
   In order to impress  this truth  on the  mind of
the medical public, I  endeavored, in  a  report on
Public Hygiene, made  to the American  Medical
Association, at its meeting in Cincinnati, in  1852, to
present it in a point of view,  in relation to human
exhalations, in which it had  not been previously
examined.  And here, perhaps, I may be permit-
ted to state the mode in which I studied the  sub-
ject, and to show its application  to the hygienic
economy of this institution.
   As the  infectious atmosphere of hospitals, ships,
jails and the squalid habitations of the poor orig-
inates, as there  is  good reason to believe, from
human  exhalations and defective  ventilation, it
becomes a question of importance to ascertain the
amount of such exhalations  from  given numbers
of  individuals  in given spaces of time.   By an
elaborate and careful  investigation,  it has been 
11
 determined that the daily  discharge  of matter
 from the lungs and skin, is greater than that from
 the bowels and bladder.
   The average  amount  exhaled  from  the lungs
 and skin  of a healthy  adult, of ordinary size, in
 twenty-four  hours, is about 40  oz. ; and of this
 quantity about 10 dwt.  consist of animal matter.
 With these data, it is easy to calculate the amount
 of effete matter  eliminated from the pulmonary
 and cutaneous surfaces, in specified periods, by the
 number of inmates which this edifice is  intended
 to accommodate.   In making such a calculation,
 it is assumed, that the  amounts emitted by  the
 sick and healthy adult persons do not  materially
 vary.  If the number of patients in this building
 be  200, then the total amount of pulmonary and
 cutaneous exhalations, will be in one day 666 lbs.,
 8 oz. ; in one month or 30 days  20,000 lbs. ;  and
 in one year  or 365 days 243,334 lbs., 4 oz. ;  and
 the amount  of animal or organic matter in these
 exhalations will be in one day 8 lbs., 4 oz. ; in one
 month 250 lbs. :  and in one year 3,041 lbs.,  8 oz.
 A similar calculation made in relation to  the  500
patients  which   the  three  buildings   on these
grounds are designed to accommodate will show a
total amount in  one  day of 1,666 lbs.,  8 oz. ;  in
one month of 50,000 lbs. ; and  in  one year  of
608,333 lbs., 4 oz. ; and  of animal  matter in the
first of these periods 20 lbs., 10 oz. ; in the  se- 
12
cond  625 lbs. :  and in the  third 7,604 lbs..  2 oz.
Such  estimates enable us  to judge of the degree
of liability of disease originating in  ill ventilated
or overcrowded human habitations.
  Among the principles eliminated from the lungs
in considerable, though variable  quantity, is  car-
bonic acid gas.  "According to Scharling," as stat-
ed by Professor Lehmann, "a very powerful adult
man exhales in twenty-four hours 867 grammes."
or,  at a temperature of 32° and the barometer at
29,84 inches, about 27,058 cubic inches.*  Air once
breathed is unfitted for the purpose of respiration,
for the reason that its normal quantity of oxygen
is diminished,  and  that of its  carbonic  acid gas
increased.  Yierordt estimates  the mean quantity
of carbonic acid in  expired air at upwards of four
per cent.f  It seems well established by  the ex-
periments of Dr. Snow, "that five or six per  cent.
of carbonic  acid  cannot  exist in  the atmosphere
respired by man,  without danger to life ; and that
less than half of this amount will soon be fatal,

  * See Physiological Chemistry,  Vol. HI, page 335, 1854—Works
of the Cavendish Society.
  f Ibid.
  "The air of an easy expiration,'" says Professor Graham, "amounts
to fifteen or eighteen  cubic inches, and contains about Z}i per
cent, of carbonic acid.  The air of  a deep expiration contains
6 or 8 per cent, of that gas, and will not support the combustion of a
candle.  According to Mr. Coathupe, the quantity of air which passes
through the lungs of a man of ordinary size, in twenty-four hours,
is 266% cubic feet, of which 20 % cubic feet are changed into carbonic
acid.—Elements of Chemistry, 1843. 
13
when it is formed at the expense of the oxygen of
the air.":;:
  Air which has not been respired, and which is
surcharged with this gas in the proportion of ten
per cent., is destructive to those who breathe it.
  But though  the  atmosphere loses by  respira-
tion a  portion of its  oxygen, and acquires an
excess of carbonic acid, and is thus rendered nox-
ious to persons in health,  and  especially so to
persons in disease, it is doubtless from  the mate-
rials  which escape  from the  body  through the
skin, and from certain  effete matters thrown off,
with the carbonic acid,  from the lungs, that hospi-
tal  infection takes its origin.  The  intestinal and
renal evacuations are usually promptly removed
from the apartments of the sick ;  and consequent-
ly the emanations from them can add but a trivial
amount to the  impurity of the air.  And,  more-
over, it is probably the animal matter present in
the exhalations from the lungs and skin which,
being in the form  of vapor,  and  not  possessing
the  peculiar  diffusive property of carbonic  acid
and other gases, is retained in the  air,  and meta-
morphosed into an aerial poison  or miasm, which
may attach itself to the clothing and bodies of the
patients, and also to the walls, ceilings, floors and
furniture of the wards in which it occurs.  In this
mode of viewing  the subject,  it is evident, that
               * Carpenter's Physiology. 
14
 ventilation is a cardinal,  and  in  fact the  only
 means of maintaining  a sanitary  condition  in
 buildings appropriated  to  the  reception  of the
 sick.  Better leave the  clothing and bedding of
 the patients, soiled by urine  and faeces, unwashed,
 than suffer the air  of an  infirmary to remain  un-
 changed.  Foulness of sheets and blankets is bad,
 but a mephitic and stagnant atmosphere is  worse.
 The visible filth of bedding and floors is  not  the
 most fertile source  of infection in hospitals.   The
 invisible matter issuing from the body in the form
 of vapor is chargeable substantially with the pois-
 oning of the atmosphere.  To the eye every thing
 in a hospital may appear clean  and pure, whilst,
 at the same time, a  deadly  principle  infects the
 air.   Such a cause of disease can only be  avoided
 by a system of thorough ventilation.
  It is here deserving of special notice, that the
 Governors of this Institution appear to have been
 fully aware of the  danger of disease  originating
 within its walls from overcrowding,  and accumu-
 lation of human effluvia.  The occurrence of ery-
 sipelas in its  wards has especially, from time to
 time, arrested their attention.  In  evidence  of
 their desire and determination to avoid the  prev-
 alence of that  disease, I shall take the liberty to
refer to what was done in relation to the subject
about 19 years ago.   In doing this, I may perhaps
revive the memory of  a document  which  may 
15
have been forgotten by some of those  engaged in
preparing it, and of which the  existence is  not
generally known.   I  allude to  the Report of a
Committee of the Governors, with the opinions of
the physicians and surgeons in relation to  erysip-
elas, presented  to  the  Board  of Governors in
April, 1836, and of which a few copies were print-
ed for  the use  of that body.   The   Committee,
consisting of Messrs. Isaac  Carow, John A. Stev-
ens, John R.  Murray,  and  George  Newbold,
were charged with the duty of inquiring into the
causes  of the prevalence of erysipelas  in the hos-
pital and the means of preventing its recurrence
in the house.
   In entering  on their inquiry, the  Committee
addressed to each of the physicians and surgeons
of the  hospital  a series of questions pertinent to
the subject.  To these questions the  physicians,
Drs. Johnson,  Beck,  Delafield and the speaker :
and the  surgeons  (excepting  Dr.  Mott,  then in
Europe,) Drs.  Stevens, Cheeseman and Rodgers,
severally returned written answers, communicating
their opinions, which were remarkably concurrent
on every important point,  and which were sub-
stantially  embodied by the Committee in their
Report to the  Board of Governors.  After notic-
ing some of the predisposing causes of the  disease
the Committee remark,  "The other,  and  gener-
ally, if not always,  the immediate, and certainly 
16
 the most fruitful source of this disease in this in-
 stitution is the vitiated or  infectious air, engen-
 dered in the wards themselves.   All the opinions,
 derived  from  the inquiries  of  the  Committee,
 agree on this point, and it is set  forth  wTith  more
 or less earnestness in every  answer ;  and to this
 conclusion,  it appears  to the  Committee,  every
 unprejudiced inquirer  must certainly arrive.—
 Hence the  greater prevalence in the winter and
 spring months,  when  external air  is excluded,
 over  the summer  months,   when  ventilation  is
 much more thorough.  Hence, in  part at least,
 its  more  frequent occurrence  in  the  surgical
 wards ;  where  open wounds, burns,  foul  ulcers,
 abscesses, and similar maladies add greatly to the
 impure air which the patients inspire ; the more
 helpless state of such patients contributes also to
 the mass of personal impurities.  Hence its break-
 ing out in the crowded  wards, whilst those wards
 that are  not crowded escape  entirely or are  gen-
 erally exempt.  The very means that are effectual
to arrest its  progress, points clearly to its origin,
and the  causes of  its prevalence ; they  are  the
use of disinfecting  agents,  vacating the infected
ward, thoroughly cleansing and ventilating it, and
removal,  for the time, of the sufferers  to open and
less crowded apartments ;  means  which never fail
of success.   These measures,  if in constant opera-
tion, would as certainly  prevent the prevalence of 
17
the disease in an endemic form.  Individual cases
would be brought into the house, or might origin-
ate in it ;  but it is the opinion of the  Committee,
that the disease would be no more likely to spread
without the existence of an infected air, the medium
of its transmission, than it would among similar pa-
tients in private dwellings.  The Committee do not
intend to enter into the  vexed question  of conta-
gion or non-contagion, infection or non-infection ;
it is sufficient for their practical  purposes, that all
agree, that it is not  contagious or infectious or
communicable but in a  vitiated atmosphere, and
not one of the replies of the physicians  and sur-
geons contemplates the exclusion  of  any erysip-
elatous patient from the hospital, from fear of its
personal communicability in the sense in which
small pox, measles or similar  diseases are com-
municable."
   This report,  so ably drawn up, was  adopted by
the board ; and its aim has at no time since been
lost sight of.   It called forth every appliance suit-
ed to prevent the recurrence of the  disease ; and
doubtless had an influence in awakening the Gov-
ernors to a sense of the importance of introducing
in the reconstruction of the interior of the main
building, in 1850, and in the interior arrangements
of this edifice,  every  modern improvement in the
architecture  of hospital and other humane institu-
tions.  The means of ventilation are here so am-
                        3 
18
pie, that should infectious diseases  show  them-
selves they will be due either to  gross negligence
in the use of those means, or to the equally perni-
cious error of overcrowding the apartments.  The
number of patients in a ward  is in excess  when-
ever the daily supply of fresh air for each is not
from 800 to 1000 cubic feet.
  The same feeling which prompted the inquiry
into the causes of eiwsipelas has induced the Gov-
ernors to cautiously guard against the occurrence
and prevalence  of typhus fever.  It is well known
that this disease furnishes exhalations,  from the
lungs and skin,  which rapidly become infectious in
overcrowded apartments. The great number of
emigrants and seamen, laboring  under that form
of the  disease denominated  ship  fever,  admitted
into the house in 1847, and afterwards for several
successive years, produced a pestiferous  condition
of the wards, which was attended by the most la-
mentable occurrences.  The  disease attacked  sev-
eral of the nurses, assistant medical  officers,  pa-
tients,  and  persons employed in  cleansing the
wards, and of whom, in  each  class,  one  or more
died.
  To prevent, in future,  perils of this sort to the
ordinary inmates, and to restore the wards to their
former salubrity, the Governors adopted  the most
efficient measures.  On the 2d of March, 1852, it
was Resolved "that cases of ship or typhus fever 
19
 be not hereafter received, until the further order-
 ing of this board."  Such are the precautions which
 have been taken to prevent the generation of in-
 fectious diseases in the house ;  and the public may
 rest assured that,  though surrounded by a dense
 population, no danger exists of the  recurrence of
 the evils which  have been mentioned, or of infec-
 tious disorders emanating from the institution.
   In making these statements, I may have awak-
 ened the expectation,  that my  remarks on  this
 occasion will of course, in part, relate to the arch-
 itectural and hygienic  arrangements which render
 this hospital a safe  and wholesome asylum  for the
 sick.   From the discussion of such topics, how-
 ever, I feel myself excused, in consequence of that
 labor having been ably and substantially performed
 by my friend and colleague, Dr. John Watson, in
 his Discourse on " Thermal Ventilation, and other
 Sanitary  Improvements,  applicable  to  Public
 Buildings," and  especially adopted in remodeling
 the interior of the main building of  the Hospital,
 in 1850, and in  the construction  of this edifice.
 This Discourse was delivered in the theatre of the
 house  on Feb. 8th,  1851; and, being printed, will
 be  a  durable  memorial  of the  intelligence  and
talent which produced it.*  There is, it is believ-
ed, nowhere to be seen economical arrangements
* See Appendix. 
20
superior to those made in this building, and in
the other edifices  of this institution, for the ac-
commodation of those who are proper objects of
admission into its wards.
  It is here the victims of casualty and disease,
the mariner, tradesman, laborer, artisan, and ser-
vant, the destitute stranger, and the poor of every
class and denomination, under certain regulations
in respect to the nature of their diseases and their
pecuniary means, are received and provided with
every comfort ; and, if medical skill be available,
their wounds healed and their maladies cured.
  The pay received from patients, as stated in the
last annual Report of the  Governors to the Leg-
islature,  " whether seamen paid for from the U.
S. Hospital money, or others paid for from their
own means, or by the aid of friends or of friendly
societies, is placed at the lowest rate, that will
meet the ordinary  average actual cost of patients,
without any allowance for the use of buildings, or
for medical and surgical  attendance."   " About
one-third are received gratuitously."
  The number of patients treated in the hospital
during the  last year was 3680.   Of this num-
ber  373 died.  Among  the  deaths were 156,
from casualties, and which occurred shortly after
the  admission  of  the cases to  the house.  De-
ducting these, the deaths were 217 out of 3,524
patients.  " Thus the practice  of the house," as 
21
the Governors say in their report,  '' presents the
following results :—Of the whole number under
actual treatment during the year, a little less than
6-nro  Per cent, died ; or, taking the ratio of  mor-
tality upon all  discharged, (as is  done in  some
statistics of this  nature,) a little above 6T:W P^r
cent.  died.  The amount of cures out of the  num-
ber under treatment shows a proportion of a very
small fraction less than 67*80  per cent,  discharged
cured, exclusive of 491, (or above 14*25 per cent.
more) discharged as relieved for the time."
   Thus far we have looked upon hospitals merely
as  great charities, fulfilling the design of giving
shelter  and relief to the sick ; but there is another
aspect  in which they may be regarded,—I  refer
to  their immediate connection with the interests
of the medical profession and the public at large.
   It  is  obvious  that infirmaries could not accom-
plish their benevolent purposes without the direct
and efficient co-operation and services of those who
have been educated in the practice of the  healing
art.  Medical men, so far as the conferring of the
benefits of medical treatment in hospitals is con-
cerned,  constitute the head  and front of such in-
stitutions.   Nor have they been backward  in as-
suming  that relation, and, in many instances, in
contributing substantially to their support.
   The  only  remuneration of physicians and sur-
geons for their  hospital  services,  besides the 
22
honor and pleasure derived from the act of reliev-
ing human suffering, is, in most instances, the
advantages of a large experience in the treatment
of many forms  of  disease, and the opportunity  of
advancing the science  and improving the art  of
medicine.
  Very many, if not the greater number of physi-
cians and surgeons who have prominently flourish-
ed,  since the  Reformation,  have occupied official
positions in metropolitan infirmaries ; and  with
some  exceptions the most valuable  additions  to
practical medicine  and surgery have been made  in
those institutions. Hospitals, therefore, may be said
to be medical schools of the highest order—medi-
cal  gymnasia where physicians and  surgeons,  as
teachers, exercise their noblest powers in struggling
with, and averting the fatal assaults of disease ; and
where pupils are trained and prepared to join the
ranks of those in the world whose duty and privi-
lege it is to combat the worst  enemies of human
comfort, and to  secure to all the blessing of "mens
sana in corpore sano."
  These remarks naturally suggest  the  inquiry,
whether this hospital has fulfilled its purpose  in
relation to  the interests  of medicine ?  Has  it
originated new, or improved the  old methods  of
treating medical and surgical diseases ?  Has  it
formed a character  which  should belong to the
first hospital in the commercial metropolis  of 
23
America, and in the third city, in point of popula-
tion, in Christendom ?  To answer these questions
fully  and satisfactorily would require more re-
search than  has been practicable within the limited
time allowed for the preparation of this discourse.
Enough, however, is within  our  immediate reach
to demonstrate that, though distant as is this hos-
pital  from  the  medical  centres  of Europe,  to
which in its earlier years it looked for instruction,
it has in later times reflected  back  to those cen-
tres,  lessons of practical wisdom,  deduced from
observation  and  original  induction ; and that its
medical officers, with the spirit  characteristic of
Americans,  have  acquired  an  independence  in
thinking and acting for themselves.
  Among its former physicians and surgeons were
men eminently distinguished for their varied and
extensive knowledge,  their  acute  power  of dis-
crimination  and medical  tact.  The  contributions
of not a few of them to the literature and practice
of medicine  were  duly appreciated  in  their own
times, and will long endure to shed lustre on their
names.
  It will be to the future historian of this institu-
tion a grateful task to estimate the  positive  and
comparative merits of those  who have acquired
renown in this field of  labor.  Without any design
to enter into an investigation  of this sort,  I shall
merely  glance at some  of the  more  prominent 
24
professional achievements of which the registers
of this hospital afford numerous instances, and of
which it may be justly proud.
  The more striking examples of rare and original
modes of practice have occurred in the department
of surgery.  There has been no case admitted into
the house, warranting and requiring an operation,
however formidable, which has not here found a
surgeon qualified by his knowledge, his eye and
heart and hand, for its performance.   Operations,
of which there were few or no precedents, and so
unpromising in their results, as scarcely to justify
their performance or repetition, have been execut-
ed with a skill that elevated the operator to  the
level of  those  enjoying the highest European re-
putation.
  The first repetition, and with a favorable result,
on this side of the Atlantic, of the  bold, original,
and successful operation of Sir Astley Cooper, of
tying the  common carotid  artery  for  aneurism,
performed by that celebrated  surgeon, in 1807,
was, in this hospital, on the 7th of January, 1813,
by the late Dr. Wright Post.  The case is recorded
with great minuteness of  detail  in  the fourth
volume of the American Medical and Philosophi-
cal Register, published in this city, in  1814, and is
the more interesting, as it contributed to establish
certain physiological and practical principles of
the highest interest.   The  same  distinguished 
25
 anatomist and  surgeon,  in  1817,  tied  the  right
 subclavian  artery, for brachial  aneurism, above
 the  clavicle.   The case  recovered, and was the
 first of the kind in which that operation had been
 successful.*  In these, as well as in all the various
 operations  of  Dr. Post,  his accurate knowledge,
 his correct judgment, his deliberate, cautious and
 delicate manner,  were striking to every observer,
 and won for him a  position more exalted in the
 profession,  than any  one since his  death has had
 the good fortune exclusively to occupy.
   In the same  wards and the same theatre of this
 hospital in which Dr. Post acquired his never fad-
 ing laurels, Dr. Mott, now one of  the most emi-
 nent of living medical men,  commenced his bril-
 liant career in  the walks of surgery.
   To the tactus eruditus and  dexterous skill of his
 distinguished contemporary, he has added the rare
 merit of originality in operative surgery.  In this
 remark I feel myself  warranted by his  operation
 on the arteria  innominata.   The  subject of the
 case was a man, aged 57, a native  American, and
 by occupation a seaman.   He  was  admitted into
 the hospital on the 1st of March,  1818, 37 years
 ago.  The operation was  performed on  the  11th
of the following May, and consisted in securing in
a  ligature the  arteria innominata, for aneurism,
  * See Transactions of the Physico-Medical Society of New-York,
Vol. I, 1817.
                       4 
26
and was the first  ever  performed for that affec-
tion.  Though  the patient eventually died from
the consequences of the  disease, the operation af-
forded a precedent which  has been followed by
other surgeons, and which will ever be associated
with  the  name of Mott, and the  institution in
which it was performed.   In concluding his  re-
flections on the case, Dr.  Mott says "the  prac-
ticability and propriety of the operation appear
to me to be satisfactorily established by this case :
and although I  feel a regret, that none know who
have not performed surgical operations, in the fa-
tal termination of it, and especially  after  the high
and just expectations of recovery which it exhib-
ited ;  yet I am  happy in the reflection, as it is the
only time it has ever  been performed, that it is
the bearer  of a message to  surgery,  containing
new and important results."
   There are other examples, in the practice of this
hospital, on record, which have been regarded as
brilliant triumphs in operative surgery.   Of these
the one which,  perhaps, in  point  of originality
and mode of execution,  has not been surpassed,
is  that of the  late Dr.  John Kearny Rodgers, in
which the left subclavian artery was tied, for an-
eurism,  on the  inner side of the scaleni  muscles.
This operation was performed on the  14th of Oc-
tober, 1845, and was witnessed by a crowd of  his
professional brethren with profound interest • and 
27
 its successful completion, at the time, and its sub-
 sequent history, notwithstanding the death  of the
 patient, on the 15th day after the operation, plac-
 ed the operator in the foremost rank of modern
 surgeons.*  The talent and ingenuity of Dr. Rod-
 gers was also  displayed in first  suggesting and
 using  wire, after  White's operation, for  ununited
 fractures,  as a means of keeping the  ends of the
 bones in apposition,  a mode of treatment  since
 adopted by eminent practitioners.f
   It will be  observed, in what I have said con-
 cerning important contributions to surgery, that
 I have confined myself to a notice of such of them
 as have been made by thosei whose  days of labor
 in  this  institution have passed  away.   Of the
 qualifications of the medical officers in active serv-
 ice at the present time, and of what they have
 done to advance the healing art, and elevate the
 character of the institution, it would not become me
 to speak as freely as I  might, were I in a different
 position,  and unfettered by  the restraints  with
 which their presence  surround  me.   But while I
 leave to others to recount whatever they have done
 in the way of improvements in operative or medical

  * The attempt of Sir Astley Cooper, the first ever made, to tie the
left subclavian artery within the scaleni muscles, is said by Dr. Mott
to have failed ufor want of the improved American artery instruments.''''
 ( Travels  in Europe and the East ; 1842, p. 21.)
  f See Biographical  Sketch of J. Kearny Rodgers, M. D., by Edward
Delafield, M. D.  New York, 1852. 
28
surgery, I am sure my colleagues will neither im-
pute to me partiality, nor  regard their associate
with jealousy, if I venture to refer to the success-
ful introduction of scarification as a means of relief
in cases of ©edematous laryngitis, by Dr. Gurdon
Buck.  Though this mode of treatment had been
previously suggested  and practiced by Lisfranc,
the idea of it seems to have been equally original
with Dr. Buck;  and it is to him  is justly due the
honor  of being the chief founder of the practice.
Several of the first cases in which  he operated,
occurred in the wards  of this hospital, in 1847  and
1848;  and  the  history  of  them, together with
drawings illustrating the  forms of the disease,  and
the instruments used in the operation, were pre-
sented to the American Medical Association, at
Baltimore, in May. 1848, and were published in
the first volume  of its Transactions.  The  oper-
ation has now taken a place  among  the resources
of art in the management of a formidable disease.
  But I  must not forget to turn your attention
for a moment from the  surgical to the medical
department of the house.  In this latter division,
there are no  salient  and dazzling points of prac-
tice, which captivate  the beholder, and tend to
aggrandize the institution. Such things spring from
the handicraft of the surgeon.   In the medical
wards  there  is nothing  which specially exposes
jtself to the gaze of curiosity, or demands striking 
29
remedial manipulations.  The  labor,  performed
here, consists in the quiet study of diagnosis, the
careful  observation  of  the  internal processes  of
disease, the unostentatious application of remedies,
and the prescription of diet and  regimen.   The
qualifications needed to discharge these medical
duties, it will, I doubt not, be generously allowed,
are quite equal to those required in the service of
the surgical wards.
   Among the names which are inseparably asso-
ciated  with the foundation of this hospital, are
those of Drs. Bard, Middleton, Jones,  and Treat;
men not less distinguished in their day for learning,
experience, and liberality, than those who have
followed them, in a long succession, in the places
they here once occupied.
   It would not accord  with my purpose on this
occasion to dilate  on the kind  and extent of la-
bors  performed by the medical men, who have
served  the institution  in the  capacity of physi-
cians.   The works of Dr. Edward  Miller, who was
declared by Dr. Rush to be second to no physician
in our country,  and  of Dr. Hosack, the erudite
and eloquent teacher of medicine, are  alone suffi-
cient, to illustrate the character of the men whom
the Governors have ever aimed to secure the serv-
ices of, and to honor.
   But while the physicians have not participated
in the imposing operations performed  in the the- 
30
atre, they have, from  time  to  time, united with
their surgical colleagues in giving regular courses
of instruction in clinical  medicine and  surgery.
It is in labors of this sort, that  a great amount of
practical knowledge has been diffused among med-
ical students, and the younger members of the pro-
fession.   The modes of instruction  have been oral
communications to the pupils, gathered at the bed-
side, or prelections delivered in the lecture room
or theatre,  and, in some  instances, subsequently
widely circulated by the  press.   As examples  of
the latter mode of teaching, I  may mention the
admirable clinical  lectures of Dr.  Alexander  H.
Stevens on the Primary Treatment of Injuries, and
on Lithotomy, the former published in 1837, and
the latter in 1838.
  I must also notice  another and more elaborate
course  of instruction, given by one of the most
talented physicians our country has produced.   I
refer to the  series of clinical lectures on  the Dis-
eases of the Chest, delivered extempore, by the
late and lamented Dr. John A.  Swett, to the class
of students attending the  hospital about ten years
since ;  and reported in the New-York Lancet,  by
its editor, the late Dr. Houston.   These lectures
were subsequently revised by their  author and  re-
produced, in 1852. in a volume of 585 pages ;—a
work which should be studied  by  every medical
pupil, and which should  adorn  every medical  li- 
31
brary.   Though more recently, Dr. Swett, without
dissolving  his  connection  with this institution,
exercised his talents, for a brief period, in giving
systematic courses of instruction in another sphere,
yet his fame will ever mainly repose on the repu-
tation he here established as a teacher of medicine.
I would fain pronounce his praise, but justice de-
mands for him  an abler eulogist.
  There is  still another mode in which a  former
medical  corps  of the house, or rather several of
them, joined in communicating to the public, the
results of their observations and inquiries.  The
plan was that of making  a selection from the
facts and cases,  coming under their observation
in the hospital, and publishing them, in the book
form, with such remarks and reflections, as might
heighten their  interest.   There is, however, but a
solitary  volume of this kind ;  and that bears the
title of the  "Medical and Surgical Register, con-
sisting chiefly of cases in the New-York Hospital;"
but it  is  one  which  occupies a respectable place
among the printed contributions which the insti-
tution  has made to medicine.   The gentlemen en-
gaged  in preparing  and publishing  it were Drs.
John Watts, Jr., Yalentine Mott, and Alexander
H.  Stevens.  The volume  comprises upwards of
400 pages, and appeared in two parts, the first in
1818, and the second in 1820.  The  initiatory pa-
per is by Dr. Mott, and relates to the case already 
32
referred to, in which  he secured  in  a ligature,
the arteria innominata.  It  also  contains a very
able and elaborate  account  of the  yellow fever,
which  appeared in various  parts of the United
States, during the summer  and autumn of 1819.
Though less extensive, the work  compares favor-
ably with the Dublin and Guy's Hospital Reports.
  Now, if to the various  modes, I  have noticed,
of diffusing the medical knowledge, derived from
this field of study, be added, that of publishing in
the medical journals, cases, and monographs, based
on facts observed in the hospital ; and if the ma-
terials thus spread before the  medical  profession,
be duly summed up and  weighed,  there will,  I
think,  be no reason to  blush in presenting the ag-
gregate, as a response to the questions before  pro-
pounded, whether  this institution has fulfilled its
purpose in  relation to the interests of medical
science?  or, whether it has originated new, or im-
proved the old methods of treating  human mala-
dies ?  We leave to others to say, if such an an-
swer be not full and triumphant.
  But the enumeration of the benefits which this
institution confers on the profession, and through
it  on the public at large, would be incomplete,
were I to omit to mention the advantages afforded
by the means of illustrating the  various forms of
organic disease by casts, and specimens taken from
the dead body, collected in the cabinet of morbid 
33
 anatomy ; or, were I to neglect to direct your at-
 tention to the treasures of medical literature accu-
 mulated in the library.
   The cabinet contains preparations of great rar-
 ity and value ;  and though recently instituted, and
 comparatively small, there is good reason to be-
 lieve, that it will  not cease to enlarge, so long as
 the medical  incumbents of the Hospital shall be
 animated by that  stern philosophical spirit of the
 age, which demands that every doctrine or inquiry
 in medical and natural science, shall be,  as far as
 possible, sustained  by  ocular and exact demon-
 strations.
   The library is nearly coeval with the institution
 of the Hospital.   In its earliest years it was en-
 riched by the donation of  books by medical men ;
 and by the appropriation of money for  the pur-
 chase of books by the Board  of Governors.  The
 funds disbursed for its enlargement have for many
 years past been derived chiefly from the fees paid
 by  medical students for tickets of  admission to
 witness the practice of  the house, and for the use
 of the books here collected. It comprises upwards
 of 5,800 volumes,  embracing works of the highest
 value in medicine  and  the  collateral sciences.  It
 is, indeed, a  fountain of knowledge  from which
the junior  of the  profession may imbibe the ele-
ments of sound medical learning, and the veteran
practitioner refresh himself with draughts of an-
                       5 
                      u

cient and modern medical lore,—a fountain suited
to every variety of professional  taste, and  which
is  gradually enlarging  by accessions flowing  into
it from the tributaries of medical observation and
research.
   And  now  it  remains that we  review  these
grounds, these buildings, and these apartments, so
spacious and  commodious, and so admirable in all
their appointments for hospital purposes ; that we
regard them as constituting a model infirmary,
embracing every improvement suggested by sci-
ence and effected by art in the course of a thou-
sand years ;  and that we contemplate them as the
exponent of the most unexceptionable and benefi-
cent form in  which philanthropy displays itself in
a Christian country.   But while  I call your atten-
tion to these things, I should fail to present the
higher claims which  this institution has to the re-
spect and confidence of the community, were I not
to advert to  the character and  social position of
those in whose hands  is the management of its
immediate and  various  concerns.  On  reviewing
the names of the  Governors from the foundation
of the Hospital, it will be perceived that they  have
been gentlemen, known and acknowledged to be
 alike distinguished for  their personal worth,  their
 practical  wisdom, their bounteous liberality and
 spirited benevolence.   The devotion of not a few
 of them to the performance of their self-imposed 
35
duties has been  extended over a long succession
of years, reaching  in some instances to periods of
more  than a third, and  nearly half a century.  I
shall 1 trust, be pardoned, if I err, in the freedom
I take on this occasion of designating the individ-
uals to whom I especially refer.  The first entitled
to notice in  the order of seniority of membership
in  the  board  of  Governors of  the past year,
is  George Newbold,  Esq., who  has  been  one
of  that body for 46 years,  and  president of the
same since 1833.  The  second is Najah Taylor,
Esq., who has been  connected with the board 45
years, and who for several years was its vice-pre-
sident.   The third is Robert I. Murray, Esq., who
has been a member for 39 years, and has occupied
the office of secretary since 1824.  The fourth is
John  Adams,  Esq , whose  term  of service  ex-
tended   through  the period  of  36  years,  and
who ably and faithfully discharged the duties of
treasurer of the  institution,  during nearly  the
whole of that time, resigning his seat in the board
in June last.    The fifth  and last  is Benjamin
W.  Rogers, Esq., whose connection with the board
commenced  with that of the Governor last men-
tioned,  namely, in 1818, and who for four years
filled  the place  of assistant treasurer, an office
long since abolished.
  These venerable men  are crowning their days
with acts of charity that will not soon be forgot- 
36
ten ; and I must add, that their honored associates
in the board, though younger, but not more zeal-
ous, give assurance that they too will  mark their
latest  years with works of benevolence alike  de-
serving of commemoration.
   Finally, in all we see around us. are recognized
the propitious influences of a pure religious prin-
ciple working in the hearts of those presiding over
the institution, and of those of their fellow citizens
who have  contributed  to  its enlargement.   Let
them  remember,  and  all  who  may  come after
them, and would imitate their noble benefactions,
that whatever of their  time, labor and substance
is bestowed on asylums for the sick and destitute,
falls within  the  circle  of charities implied in  the
proverbial declarations  of Scripture, "He that
hath pity upon the poor, lencleth unto the Lord ;
and that which he  hath given  will  he pay  him
again."  " He that giveth unto the poor shall not
lack." And let those who here exercise their skill
in  the healing art, remember the  saying of the
illustrious- Boerhaave,  "that the poor  were his
best patients,  because God was their paymaster." 
APPENDIX.
DESCRIPTION OP THE NEW SOITH BUILDING OP  THK \E\V YORK
                         HOSPITAL,

           BY  JOHN  WATSON, M.  D.,
                   SURGEON OF THE HOSIMTAE.
  The spacious and commodious stone edifice recently erected
on the grounds of the New York Hospital, covers a space of 128
feet  from east  to west, by 90  feet from north to south ; ranging
parallel with  Duane Street, and  receding  westward, from the
main or  central building of the hospit.al,  to within  30  feet of
Church Street.  Its elevation from the foundation, four feet be-
low  the f urfacc of the ground,  to the peak of its roof, is about
equal to  its width.   The  roof has a pitch of 12 feet, and the per-
pendicular walls in front  and rear, from the surface of the ground
to the top of the cornice, are  about 74 feet high ; and the gable
ends, rising to the  top of the roof, are equal to the upmost eleva-
tion  of the roof itself.   The  platform  upon which the building
rests has been leveled out of the side of a hill with a rapid decliv-
ity towards  the south  and west, so that the  embankment at the
north and east, at its highest point, is about  12 feet above the
surface of this platform.   This embankment,  sloping off to the
south and west, is  faced,  at its highest level, with a perpendicular
wall  of cut stone ;  but where less abrupt, it is sloped off gradually
and covered with green sward.  There is an area, or open interspace
between  the embankment and the  outer walls of  the building, of
from  4 to 8 feet wide ;  so that light and air  have free access to
the sub-basement, or foundation story, as well as  to the four sto- 
38
ries above this, on every side.  The building consists of two pro-
jecting wings and an intermediate or central portion.   The wings,
above the foundation story, are the parts more especially intend-
ed for  the  wards of the  sick.  Measured from without, in the
principal story, they are in length, from north to south, 88  feet;
and in width, from east  to west, 47 feet  1 inches.  They project,
both in front and rear, about 12  feet beyond the perpendicular
walls of the  central portion.  This latter is about  66 feet deep
from north to south, by 33 feet 4 inches from wing to wing  ; and
is occupied with  the several small rooms of the resident medical
officers  and assistant superintendent, with  the principal entrance
or vestibule, with spacious halls ten feet wide, with  the principal
stairway ; and in  the uppermost story, with the surgical amphithe-
atre and small apartments  connected with it.  The sub-basement
or foundation  story, is  wholly above  ground on  two sides, and
partly so  on the  other sides, and is  well aired and lighted on ev-
ery side.   It is 10 feet high from floor to ceiling, traversed from
east to west  by  a wide hall, and  crossed at  three points by lob-
bies, one in each wing, and one in the centre.   On  this floor are
eight air chambers, for the accommodation of the  heating and
ventilating apparatus ;  and numerous offices and small  apartments
for the  use of the servants and laboring people  about the premi-
ses.   The access to this story from without is by a door at either
end of the  principal  hall ; and  it communicates with the story
above it by the principal stairway in the centre.   The basement,
or the story affording the principal entrance, is 14 feet high from
floor to ceiling,  and  is traversed through its whole length by a
hall 10 feet  wide.   It is approached by the principal  entrance in
the  centre  on the  north  side, not more than  two  steps above
the  level  of the open space in  front; and by two doors  at
 either  extremity of the great hall east and west.   The principal
stairway  on  the south of this hall is  opposite the  central en-
trance, with which  it communicates through the vestibule.   But
 there are  also other stairways, one  in each wing, ascending from
 this floor  to the uppermost  story.   These smaller stairways arc 
39
constructed of iron, and are intended to furnisb safe escape frord
the several wards in case  of fire or panic, as well as to give pri-
vacy to  the  wards,  and  relieve the centre of the building from
noise and bustle.  The wards for the sick in this floor are four in
number, each  about 27  by 38 feet; and, like the  larger wards
above, are furnished with all the requisite offices and appurtenan-
ces.   Each of the three stories above the basement is in height,
from floor to ceiling,  15 feet.  On these are all .the principal
wards.
   Each  of these wards consists of—1st.  An  infirmary  or sick
room,  intended to accommodate about 30 patients,  and measur-
ing within the walls $1 by 27 feet   2d. A nurses' room, of suffi-
cient  size for two nurses, (the number assigned to every ward.)
3d.  A  refectory, or eating room, with its requisite appliances,
dumb-waiter, cupboard,  sink, &c.   4th. A  common  room, in
which  are ranges of drawers for the clothing of the patients and
the furniture of the sick room, when out of use.   Each patient has
here a separate drawer in which his own clothing is kept.  This
room is also to be used as a retiring room for conversation, and for
the  recreation of convalescents.  5th. A small spare  room for
the  seclusion of special  cases.   6th. A  transept or recess, 10
feet wide, on the  side  opposite the  door which  opens  upon
the  central hall.  Communicating directly with this recess, and
through it, with the sick room, are, on one side, 7th. the water-
closet  and bath-room ; and on the other side, Sth. the doorlead-
ing  to  the private  stairway already mentioned.  Each ward  is
lighted on every side by spacious windows reaching to  the floor;
but  the ventilating  arrangements are independent of these, and
are, perhaps, even  more efficient  in  the  winter time,  while the
windows and  doors  are shut, than when the steam is off, and
all the windows are open to the air, in the summer season.   Such
at least, is the fact in the main hospital edifice, within which this
improved system of heating and ventilation has been in operation
now for  several years,  and in which the patients suffer less from 
40
 erysipelas and other depressing maladies from impure air, in win-
 ter than in summer.
    The fresh air, when the windows and doors arc closed, is intro-
 duced  from without through two upright shafts, each at the dis-
 tance of twenty-six feet from the house—one opposite its eastern,
 and the other opposite its western entrance.  Passing downwards
 through each  of these  shafts, by  an opening of 4 feet 4 inches
 square, the air enters  a horizontal continuation of this opening,
 and is  conducted through this, onwards several feet beneath the
 surface  and parallel with the main hall, towards the  central por-
 tion  of the  building ; and reaching, in this  course, the smaller
 conduits in communication with the air chambers, it enters these
 through openings in the floor ; and here, exposed to coils of steam-
 pipe, it receives the requisite temperature  in the chambers, and
 is allowed to escape upwards by separate flues  for each point  of
 destination, into  the  wards or other apartments of the building.
 Each of the principal wards  receives through the wall, near the
 floor, fresh air by four flues, which arc constantly open, and reg-
 ulated  by  registers wholly beyond the  control of the patients.
 The foul air of the wards and other apartments, is carried off by
 upward currents through the chimneys to the open air, by special
 foul-air flues, which communicate with open belfreys in the attic.
 Of these belfreys or cupolas there are four, two to each wing ; and
through these an upward current is constantly secured by coils of
heated steam pipe placed within them, and which can be kept in
operation winter  and summer, independent of the  apparatus for
warming the house.  In each of the large wards  there are two wide
chimneys—one  at either end, and  from  thirteen  to  fifteen
special  foul-air flues ranging lengthwise along the sides of the
ward, with registers at top and bottom alternately.  There is also
a smoke-flue for each of the air-chambers, so that stoves or other
beating  apparatus may be  used,  if  the present plan should be
abandoned.
  The following table gives the internal diameter in inches, and
the length in feet, of iron tubes used in the economy of the house, 
41
for drainage, for the supply of water, for gas, and for the heating
and ventilating apparatus:
Diameter   4

Length,
534
16.S2]
1	H	li	2	2i	3	3i	4 in. I
							— i
11.677	SKI	1499	1045	161	62	52	156 ft. 1
The length of steam pipe in the eight air chambers alone, includ-
ing bends, is equal to about 29,250 feet of f inch tube,—supply-
ing about five lineal feet of such tube for every hundred cubic feet
of space  within the building to be heated, making due allowance
for waste of heat through  windows and doors, as well as for the
unremitting process of ventilation.
   The  water-closets  are  ventilated  by  a  downward current.
There arc no traps connected with the seats, but the air, descend-
ing with the soil and foul water, is drawn off at a point just above
the  bottom  of the perpendicular soil shafts, and conducted hori-
zontally  under ground, through  iron  pipes,  till it reaches  the
smoke-shaft coining from the  furnace  room, into which  it  enters,
and, together with the smoke  and  heated gases of the furnace, is
carried off through the high chimney of the main building.   The
liquid soil,  separated from the current of descending air, after
reaching the ground, passes  through  a trap which  prevents re-
gurgitation, and is thence  conducted  under ground to the public
sewer in Duane Street.
   The whole building will accommodate from 240 to 250 patients,
affording  each  of these not  less  than a thousand feet of cubic
space, and a circulating current of air, when  the ventilating ap-
paratus is in operation, of  not less than half a  mile an hour ;  and
on an average probably three or four times that amount. Among
the  labor-saving  contrivances not to be  overlooked, and beyond
those already mentioned, are  :—1st, speaking  tubes communica-
ting with each of the wards ;  2d, a descent-shaft for  the passage
of clothing,  bedding,  &c, from the wards to the ground floor, or

                              6 
42
in  the  contrary direction;  3d,  a  hoistway  and platform  for
raising  the  crippled  and disabled patients  from  the  basement
floor  to the  several  wards above ;  4th, gas fixtures  in  every
apartment;  5th, four water tanks of  iron, holding in  all about
frm* thousand gallons, placed in  the  attic, and  supplied  with
water by a forcing-pump, worked  by a small engine, which  is
placed  in the furnace-room, more than a hundred feet from the
building.  The  water, in two of  these tanks,  is kept  constant-
ly boiling by means of steam-pipes,  which  are  placed within
them.   Each ward and private room  of the house is, by means of
these tanks,  abundantly supplied  with hot and cold water ; and
the general  arrangement is such, that each ward may be wholly
secluded from the rest, and may be said to constitute  a  complete
infirmary within itself.
  The  surgical  amphitheatre, in  the  centre of the upper story,
towards the  north,  is  lighted through the  roof by  a  circular
dome of glass, and by side windows opening  to the north.   The
circular space within  which the operating table rests, is surround-
ed with ranges  of seats, rising from the floor, and by a circular
gallery for similar seats above ; and the whole apartment is so ar-
ranged  as to  furnish a perfect view  of the operating table from
every seat, and to accommodate about 250 persons.
  The building  is of the most substantial materials.   Its walls
are  of gneiss, from Westchester County, N. Y., and its total cost
will vary but little from  one hundred and fifty thousand  dollars.
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DELIVERED ON THE
    OCCASION OF  THE INAUGURATE

              OF THE


NEW  SOUTH  BUILDING
OF THE
NEW   YOEK   HOSPITAL,
ON THE 18TH OF APRIL, 1855.
  BY  JOSEPH  M. SMITH, M. D.,

SENIOR PHYSICIAN OF THE NEW-VORK HOSPITAL J PROFESSOR OF
   THE THEORY AND PRACTICE OF PHYSIC AND CLINICAL
      MEDICINE IN THE NEW-YORK COLLEGE OF
         PHYSICIANS AND SURGEONS,
              fcC., <feC.
              NEW-YORK :
S. T. CALLAHAN & CO., PR INTERS, 113 NASSAU STREET,
1855. 
 
 
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