IMAGE EVALUATION TEST TARGET (MT-S) // // Y '"^4 A r/. ^d? 1.0 I.I bi|28 |2.5 ut Uii 12.2 L£ 112.0 Hi tli u 11.25 i 1.4 1.6 '^ ^ '^ CIHM/ICMH Microfiche Series. CIHM/ICMH Collection de microfiches. Canadian institute for Historical IMicroreproductions institut Canadian de microreproductions historiques 1980 Technical and Bibliographic Notas/Notes tachniquas at bibiiographiquas Tha Institute has attempted to obtain the best original copy available for filming. Features of this copy which may be bibllographically unique, which may alter any of the images in the reproduction, or which may significantly change the usual method of filming, are checked below. u D [Z^ D D D D Coloured covers/ Couverture de couleur I I Covers damaged/ Couverture endommagte Covers restored and/or laminated/ Couverture restaur^e et/ou pelliculAe I I Cover title missing/ Le titre de couverture manque I I ColoureJ maps/ Cartes giographiques en couleur Coloured ink (i.e. other than blue or black)/ Encre de couleur (i.e. autre que bieue ou noire) I I Coloured plates and/or illustrations/ Planches et/ou illustrations dn couleur Bound with other material/ Reiii avec d'autres documents Tight binding may cause shadows or distortion along interior margin/ La reliure serr^e peut causer de I'ombre ou de la distortion le long de la marge intirieure Blank leaves added during restoration may appear within the text. Whenever possible, these have been omitted from filming/ II se peut que certaines pages blanches ajout^es lore d'une restauration apparaissent dans le texte, mais, lorsque cela 6tait possible, ces pages n'ont pas 6t6 fiimdes. Additional comments:/ Commentaires supplAmentaires; L'Instltut a microfilm^ la meilleur exemplaire qu'il lui a hxh possible de se procurer. Les details de cet exemplaire qui sont peut-dtre uniques du point de vue bibliographique, qui peuvent modifier une Image reproduite. ou qui peuvent exiger une modification dans la m6thode normale de filmage sont indiquAs cl-dessous. I I Coloured pages/ Pages de couleur Pages damaged/ Pages endommagies Pages restored and/oi Pages restauries et/ou peiiicuiies Pages discoloured, stained or foxec Pages dicoiordes, tachaties ou piqudes I I Pages damaged/ I I Pages restored and/or laminated/ I I Pages discoloured, stained or foxed/ □ Pages detached/ Pages d^tachdes r~l^ Showthrough/ IJlI Transparence I I Quality of print varies/ Quality indgaie de {'impression Includes supplementary material/ Comprend du materiel suppiimentaire n Only edition available/ Seule Mition disponible Pages wholly or partially obscured by errata slips, tissues, etc., have been ref limed to ensure the best possible image/ Les pages totalement ou partiellement obscurcies par un feuillet d'errata, une pelure, etc., ont 6t6 film^es d nouveau de fapon d obtenir la meilieure image possible. This item is filmed at the reduction ratio checked below/ Ce document est filmA au taux da rMuction indiquA ci-dessous. 10X 14X itx 22X 2SX 30X J 12X lex 20X 24X 28X 32X The copy filmed here he* been reproduced thanks to the generosity of: Library of the Public Archives of Canada The images appearing here are the best quality possible considering the condition and legibility of the original copy and in keeping with the filming contract specifications. Original copies in printed paper covers are filmed beginning with the front cover and ending on the last page with a printed or Illustrated impres- sion, or the back cover when appropriate. All other original copies are filmed beginning on the first page with a printed or illustrated impres- sion, and ending on the last page with a printed or Illustrated impression. The last recorded frame on each microfiche shaM contain the symbol ^^ (meaning "CON- TINUED"), or the symbol y (meaning "END"), whichever applies. L'exemplaire filmA fut reproduit grAce A la gAnirosItt de: La bibliothique des Archives publiques du Canada Les images sulvantes ont *t4 reproduites avec le plus grand soin, compte tenu de la condition et de la nettetA de rexemplaire filmA, et en conformity avec les conditions du contrat de fllmage. Les exemplalres originaux dont la couverture en papier est ImprimAe sont filmAs en commenpant par le premier plat et en terminant soit par la derniire page qui comporte une empreinte d'impression ou d'iliustratlon, soit par le second plat, salon le cas. Tous les autres exemplalres originaux sont fllmAs en commenpant par la premiere page qui comporte une empreinte d'impression ou d'illustration et en terminant par la derniire page qui comporte une telle empreinte. Un des symboies suivants apparaltra sur la derniire image de cheque microfiche, seion le cas: le symbols — ► signifie "A SUIVRE", le symbole ▼ signifie "FIN". Maps, plates, charts, etc., may be filmed at different reduction ratios. Those too large to be entirely Included in one exposure are filmed beginning in the upper left hand corner, left to right and top to bottom, as many frames as required. The following diagrams illustrate the method: Les cartes, planches, tableaux, etc., peuvent Atre filmis & des taux de rMuction diff6rents. Lorsque le document est trop grand pour Atre reproduit en un seul cllchA, 11 est filmA A partir de I'anglo supArieur gauche, de gauche A droite, et de haut en bas, en prenant le nombre d'images nAcessalre. Les diagrammes suivants illustrent la mAthode. 1 2 3 f ! 2 3 4 5 6 Ci)/k^M. Compliments of R. W, GARRETT, M. ■ ) KINGSTON. ONT. S^. ' , ' •* Surgical «' ! >■ > —» ■ ■■ ■■—' ■^■« * O^vaxic^s. WWUHMMMWVa €qutpmcnt. \. :> ^ - 4 ^ ItiJi ^{aA^^^^^^^^^^ «« rS^^ ^^^ r KING one's course throtif;h life there are some offices to be pertormed through necessity, some tlirou^'h a sense of duty, and some from the pleasure they afford, but of the many duties that have fallen to my lot none has afforded me more sincere gratification than to have to-aay's opportunity of expressing on behalf of the surgical, and I think I may say also on behalf of the medical staff of the Hospital, their appreciation of the magnificent gift of this operating room, by our esteemed co-worker, Dr. K. N. Fen wick. I do not think any of us can, on first consideration, appre- ciate the power for good which the doctor's gift has put in motion, the momentum of which will be felt in an increasing ratio for years to come, for we would have to take into considera- tion the myriads of lives that will have been spared, the count- less pains that will have been alleviated, and the burdens of sorrow that will have been uplifted from suffering humanity by the advantages which this modern operating room offers, and which could not be offered under previous existing circum- stances. This is a progressive age, and the Hoard of Governors, imbued with the spirit of progress, have not lagged behind. The visitors who entered its portals fifteen years ago, were they suddenly transported to the scenes of to-day, would be struck with amazement at the gigantic strides that have been made. When speaking of the work of to-day, it is not my wish to mini- mize in the least the work of those who formed its main support from the time of its establishment in 1H44. Theirs was often an uphill and discouraging work, but notwithstanding for over fifty years this hospital has extended its sheltering arms with ten- derest love and care to the suffering of every class and creed, the inspiring impulse of the governors being that human- ity's call for aid should never go unheeded. •I» — 4— F.acli year, as lime nilltd on, saw cliaiif^cs and iinprovt!- niL'iits as ncrcssity tieniaiulcd, until now, npon tlic foinulation laid in years {^onc hy llicro has ix-cn raised a sn|)t'rstrii(tnie perf<^(Jt in its parts and lionorahlc to the i)uiKlers. Within the last lilt<'eii or twenty years the whole features of hospital work have ehaiim-d. As an outcome of recent research a new work has risen nji for it, which demands for its success a thoronj^h technicine, skilfid nursing; and ho(h1 hygienic surroundinf,'s. In days gone by the work was considered complete when it furnished food, shelter and medical attendance for the sick poor, supplying in cleanliness those comforts which their own surroundings denied them. Thus it was that our Hos|)ital was filled with the poor only. l"ew beyond such occupieil a bed in the wards or applieii for medical treatment. Those in other stations of life only darkened the threshold to perform some kindly office, or to speak some word oi comfort to its occupants. Allow me, for a moment, to point out the causes which have led to such transformations in hospital management, ecpiipnu'Ut and techni(|Ue. and which bring to us to-day patients from every class and station in life for treatment. When Sir Joseph Uster announced his gospel of Antisepsis there burst upon tin; smgical world a new light which shed its rays to every corner, and a n(>w era was given to medical science. No longer ago than iSyf), \'on Langenbeck was heard to say at a Clinic in Berlin: " \ new method has been advanced by an English surgeon, who predicates the principle of wound treatment upon the destruction of organic germs, which he assumes to be the cause of wound disturbances. The excellent results claimed by him are not in accord with those we obtain, hence I can hardly grasp their perfection ; yet, notwithstanding n»y experience, I feel it incmubent upon me to test them ui practice." The old master, then reputed throughout the world as the father of joint-resection, did not hesitate to become the pupil of yomig Richard Von V'olkman, who had just returned from London, having there studied the methods of Jo.scph ' ister. Von Langenbeck was soon convinced that Listerisni was not a phantasm. The curse of centuries was ended. While before antise()sis eighty per cent, of ail wounds treated at the Univei'sity Clinic at Munich were afleCted with hospital gang- rene, this disease was now looked upon l)y the students as a a Z O z o _ 13 o z ? -I < o c 2 s z uJ UJ I ••.» — 6- rarity. I'ormorly the mortality from amputations reached even sixty per cent. ; thcncclnrth (heaths (Hn-ctly trac('ai)it' to amputations were the exceptions. Amciriea was not slow to feci the |)owerliil impetus, and my esteemed lri«'nd, .\. 1'. (ierster, in his excellent worU, " .Aseptic and Antiseptic Sm^ery," was the first to brinj; I-isterism to the front. Closely followinj; the vanguard was Midwifery, into which important branch of practice antiseptic snrj^ical prin- ciples were soon introduced for which Henry J. (iairif,'ue deserves especial credit, as well as the renowned Oliver Wendell Holmes. Notwithstanding the mij^'hty upheaval in surf^ery made hy Antisepsis, the prof,'ressive tendency of surgery did not permit Listerism to rest upon its achievements. The advance move- ment was primarily manifested in hacleiiological invtistigations, and through the agency of such investigations, conducted over a period of seven years, from 1S81 to i8iSH, Robert Koch was abl(> to announce and prove by indisputable evidences that the microbes foinul in the atmosphere were nuiinly of an nmocuons character. With the acknowledgement ol this faCt came the downfall of the " Spray " and the birth of Asepsis. Under a conscientious practice of this method delicate structures are now saved from contact with toxic substances, such as carbolic acid and corrosive sublimate ; wounds are found to heal without re-action ; skull and abdomen are oj)ened without thought of danger, and operations are now performed daily which, before the dawn of the new era, would not have even been conceived by the boldest or most reckless operator. It reduced the death rate in amputations to two per cent., while in the early period of Listerism the death rate was sixteen per cent. The mortality from laparotomies fell from fifty per cent, to less than ten per cent., and to-day I am afraid to state how low the percentage is, so rapidly has the death rate declined. The same strides have been made in midwifery, as shown by the recent report of four hundred births at a maternity asylum in New York, without a single death. The views and methods now in use will doubtless change somewhat. The use of the microscope has sapped the very foundations of the pathology taught twenty years ago, and to- day we are still endeavoring to wring from nature, by means of experimentation and biological research, those manifold niys- -7— THE DORAN BUILDING. »• — 8— teries which cHnical observations have failed to reveal ; hut whatever these chaiif^es may be, they cannot disturb the glorious foundation laid by Joseph Lister. To Lister we owe the mother Antisepsis, and though she died in parturition, she brought forth her ideali/:ation, Asepsis. With such magnificent results achieved in other places, brilliant before us, it was but the duty of the Hoard of (jov- ernors and of staff to take advantage of those reformations in order that they might share some of the brilliancy, if not add new lustre to it. When we know that aseptic surgery means the life and well being of the sufferer under favorable circumstances, and septic surgery means death under any circumstances, it is but our duty to carry out its principles in their minutest details, follow- ing its fundamental laws with almost slavish servility. As a chain is no stronger than its weakest link, so surgery is only as aseptic as its weakest point. In order that success may follow in our wake, it is necessary to make every link in the great chain of management as strong as any link ever forged for hospital work. " Tempora mutantttr et iios iiiutaiuur in illis." If, then, we hoped to achieve all that asepsis promised, a change in the nursing was urgently demanded, and thus it was that a small training school, with one superintendent aud two nurses in training, was initiated. The great vantage ground thus gained was soon seen in the improved nursing in the wards, while the general public was not slow to see the benefits of a trained nurse. The demand for educated, intelligent women, specially trained to wait upon the sick, became so urgent, that to-day, to supply its requirements and those of the warda the services of twenty-one nurses are demanded. A Medical Superintendent was added to the staff to oversee and manage the general internal arrangements and to have constantly on hand a properly qualified pra(5titioner to meet urgent demands. Originally there were four Medical Officers and two House Surgeons; now there are nine, divided up into various departments, and four House Surgeons. For years it had been felt that there should be some classi- fication of patients according to their diseases, or in other words that those suffering from infectious and contagious diseases should be isolated. For that work Mrs. Nickle generously — 9- THE DORAN BUILDING. (Side View.) donated snfl-icicrit iiioiiry to orecH that massive biiildiiif,' known to all of us as the XitUle WiiiK- This hiiiltHnf( is approached by a separate stairway and is t lit oft from the main buihhnf.' l)y open f^alleries. It is heated and ventilated by the Smeail-Dovvd system and has the most perfect sanitary fittings. L'p to October, iScji, no special jirovision had been made for the r(>ception of children; they were scattered throughout the wards, which for obvious reasons was considered midesir- able. With the erection of the Nickle Wing the (iovernors were able to set apart for a children's ward, a large, bright, airy room, in the WatUins Wing. For the name, " St. Andrew's Children's Ward," the children belonging to St. Andrew's Church undertook to prejnire, furnish and fully e([uip the ward with everything necessary, and to take an abiding active interest in it. The private rooms are located in the Watkins Wing, a plain, substantial building, erected many years ago through the generosity of Mr. John Watkins, a Kmgston citizen. These also have been so neatly and completely furnished by kind friends as to offer those requiring hospital treatment all ...le comforts of home Hie, with, in addition, nurses constantly in attendance. The old Mott ward was taken in hand by the ladies of St. George's Cathedral and fitted up for a medical apartment for women. The transformation that has taken place here is truly marvellous. The high modern iron bedsteads enamelled white, spring mattresses, spotless white linen, and scrupulously clean hardwood floor, give one, on entering, a feeling that is at once refreshing and full of hope. Sampson, Vates and Strange wards have all been similarly improved. Tables especially constructed for the purpose are at each bedside, on which the meals are served in tasty dishes. The main entrance has been brightened by plate-glass doors ; the old, small-light windows have been replaced by win- dows in plate and ornamental glass, the effect ot which has been to give an improved tone to the whole building. Turning our thoughts to the outside one cannot help notic- ing how attractive the grounds have been made. The mound, after being for fort> years given over to wild grass and weeds, has been laid out in a picturesque flower plot and surmounted by a beautiful marble figure, the gift ot His Grace Archbishop UJ QC I— < UJ X I- I Q- 5 < UJ z UJ I o 5 •/ — 12 — denary ; tlie old wixxlen fence has been replaced by a substan- tial stone wall ; the ground on the south side of the main build- my, has been neatly laid out as a grass plot, and is regularh- mowed and kept in trim. A driveway, neatly rounded off with ashes, has been made, and new iron f^ates with ston( piers set up. The plot in front of the buildings is tastefully laid out in flower areas, in the midst of which is an ever-flowing fountain tlie gift of Mr. H. W. Robertson. The Doran Building is a model in every respect and pro- vides for the special care and treatment of women. The main entrance presents a handsome vestibule and staircase, furnished in hardwood. On the right is a room for visitors, on the left is the head nurse's room. Passing on we come to the oper- ating room on the right, a room which has been much admired for its completeness by expert judges. On the left are six pri- vate rooms, each one with a gas grate and neatly though plainly furnished. On the second floor are the maternity wards, so ar- ranged as to classify the inmates. The whole building is heated by hot water and ventilated by a fan kept in motion by an electric motor. It would be hard to find a more complete building for the purposes for which it was intended. The room which we occupy today speaks for itself, for its beauty of design, tor its elegant and chaste appearance, and for its thorough ecpiipment and modern appointments, I have no hesitation in saying that it has no rival in Canada and very few in the United States. But we must not stop here; the present progress must be an incentive to us to press on and continue in the good work so well inaugurated, for you may " Count that day lost, whose low declining sun, Sees no good deed in worthy action done. " Ul > UJ _J _J < S o < Z liJ cr < (J z »- < UJ a. O ^'^ THE NEW AMPHITHEATRE. /•Vow Hritish M^/iig\ Oct. 13th, iSgs. It is ail old and true saying that " time works many chanj^es."' This adage is verified hy a visit to the (ieneral Hospital, and a comparison of its present efficient condition, new buildings, modern fixtures, new ideas everywhere, and as it existed some ten or a do^en years ago, with its old-fashioned s(}uare main building and the plain but substantial Watkins Wing tacked on the east side. What a metamorphosis in so short a time ; it is far beyond what the most fertile brain at that time ever dreamed of ! Look to-day at the tremendous advance- ment, at the institution as it stands to-day, its group of beautiful structures wherein the rich and poor are treated alike and given the most advanced treatment modern science has prescribed, while surrounded with all the luxury that taste could suggest and wealth procure. The latest addition to the fine group of buildings is the Fenwick Operating Amphitheatre, claimed to be among the finest of its class on the continent. It is situated in the rear and slightly to the east of the main building, from which it is easily reached. The building is semi-circular in form and covers an area of 1,580 square feet. The walls are of local limestone, rock-faced ashlar work, with cut limestone dressings. The interior of the building is finished in white pine, and the walls are plastered with rock-wall plaster, from Hillsborough, N.B. The floor of the arena is of slate and its walls of polished Italian marble. The ceiling is of ground glass, containing about three hundred square feet, through which the light Is diffused from a large sky- light in the roof. In addition to the sky-light, the arena is lighted by ten circular headed windows placed in the walls of the building. Rising above the marble dado enclosing the arena, at a good elevation, there are three rows of semi-circular seats, affording ample accommodation and view for one hundred students. * The interior is approached from the main corridor by an- other corridor, on the right of which, as one walks down, are the sir- ;ical supply, recovery and ana'sthetic rooms, while on the r 1 A ? —15— left is a (lark rfioiii for i-yc; and throat work, and tlit; stirpeon's room, fittfd up with apartments for operatiiiK robes and contain- irifj a handsome instrnment case, the f,'ilt of Dr. I'leminf^, a grad- nate of last spriiif^. The recovery room is e(|iiipped to treat all accidents or complications that may occur dnrinj; or after opera- tions, and in this room patients are delayed until recovery from tlu! amesthetic 's complete. The an:esthetic room is e(|uipped with all the necessaries recpiired during the administration of an ana-sthetic, and the usual restoratives in case of threatened danger. A jiathological room adjoins the an;esthetic room, and is so furnished that microscopical and other investigations can he undertaken and completed at any stage of an operation. This room was fitted up through the kindness of Dr. Wood. The operating room, on entering, must at once strike the eye of even the most careless observer with tlie idea of perfection ; its beau- tiful white walls, white enamelled seats and hand-rails, rich Italian marble dado ; its marble and plate-glass shelves for basins and glassware give an idea of symmetry, beauty and rich- ness seldom if ever seen even in the most modern operatmg room. The arena is furnished with an lulebohl's operating table, with the Morris extension ; three glass tables for trays and in- struments, a boiler for sterilizing water, and two sterilizers made of polished copper. On either side of the arena are sets of water basins, furnished with hot and cold water taps, for the necessary ablutions. The glassware, complete in every detail tor operating purposes and for retaining sterilized dressings, towels and other similar material, is the gift of Dr. A. P. Chown. A large beautifully lighted room below, 35 by 26 feet, fur- nishes a waiting room for students and others, while adjoining it there is a cloak and wash room. The stairway leading to the room above affords easy access to the scats in the amphitheatre or to the wards. The sanitary ware throughout is of the most modern and perfect kind. The building is thoroughly heated by hot water, and is ventilated with warm air shafts. Neither time nor money has been spared to make it an ideal operating room, and the architect, Wm. Newlands, who has devoted much of his time and attention to it, should be proud of the success which has crowned his efforts.