What I saw on the west coast of South and North America, and at the Hawaiian Islands.: By H. Willis Baxley, M.D.

HOSPITAL OF SAN ANDRES.
the duties demanded for the care of the following institutions
supported by this munificent trust:
1. The Hospital of San Andres, for men, consisting of a large
central room surmounted by a dome; from this room radiate
several long and commodious wards with high ceilings. Each
ward has light admitted from above, there being no side windows for the accommodation of impertinent curiosity, or to elndanger patients by draughts of air, atmospheric purity being
secured by suitable ventilators above and below. The floor is
of highly-polished asphaltum-easily cleansed. Neat iron bedsteads have superseded here, as they should in every hospital,
the more cumbrous and less durable bug-breeders of wood, and
bedding is abundant and clean. Closets, bath rooms, and an
ample supply of hot and cold water, and all accessories needful
for the comfort of the sick, and the convenience of the convalescent, are provided. Each bed is numbered, and has suspended
at its head in brief, the daily medical record of the occupant's
condition. A permanent dressing-table in the surgical ward
has numerous drawers, supplied with necessary dressings and- instruments to meet sudden emergencies; charpie, rollers, cushions, sponges, plasters, ointments, can be had at a moment's notice, and without the delay often realized in similar establishments at home for such articles to be brought. The operating
room is spacious and well lighted, and the attendance of internes upon the visiting surgeon, the quiet and orderly manner
of performing their respective duties, each having his specially
assigned office, and no one interfering with that of his colleague;
the personal presence, also, of the nurse to give information if
sought, and to makle, herself, a note of the prescribed dies, as
the chief interne does a record of the progress of the case, and
the assistant that of the medical prescription; the presence, too,
of a servant with water and napkin for the surgeonin-i-echlief, so
that each patient shall be examined with unsoiled hands; and
numerous other evidences of order, decorum, foresight, promptitude, cleanliness, and discipline, are entitled to commendation,
and make San Andres a model worthy of North American imitation. The larger wards are occupied by charity patients, and
these are certainly more comfortably provided for than any simi
121