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HOSPITAL NURSES

IN LONDON AND ON THE CONTINENT.

BY MRS. BREWER.

CHAPTER VI.-BUDA-PESTH AND MILAN.

were anxious to see the hospitals and

WR system of nursing at Buda-Pesth, and

therefore on leaving Vienna took that route to Italy rather than either of the others. Pesth is barely six hours' distance by rail from Vienna, yet how wonderfully different are the cities and the peoples.

On our way through the streets of Pesth to the hospital we were much interested in the chemists' shops, over each of which hung a sign "To the Saviour," "To the Holy Trinity," etc., bearing witness to the fact that the Hungarians regard the art of healing as sacred.

The large hospital in Pesth is more like the general hospital in Vienna, and what we saw of it distressed us equally. There seemed no order or cleanliness about it, and it was impossible to find any person of authority. For more than an hour we marched round and round dirty, cheerless corridors, in search of some one who would give us permission to go over it, but without effect, meeting on our way, however, unattractive nurses, convalescents in greasy soiled dressing-gowns, and helpers equally unkempt, carrying the unappetising food from the kitchens to the wards.

We were not successful in getting into the wards or kitchens, so we can say little or nothing of this hospital, except that it adheres to the old style of nursing and administration, which we are striving so hard to get rid of.

We were more successful in our visit to the Elisabeth Hospital on the Buda side of the Danube, across which we went by the magnificent suspension bridge known as Clarke's Bridge.

This hospital standing out of the town on a hill is built on the Pavilion principle, and nursed and managed by Red Cross Sisters.

In time of war it would be wholly devoted to wounded soldiers; but in time of peace it is used as a general hospital for the people of Buda-Pesth.

It consists of four pavilions and nine barracks, and when in full use would accommodate eight hundred wounded soldiers. In time of peace, however, the four pavilions alone are used, and enable the authorities to receive a hundred and twenty patients.

Two of these are devoted to separate or paying patients, and two to the non-paying.

Each pavilion is provided with four good large bathrooms and supplied with every conceivable necessary and comfort.

A first-class separate room costs six guldens a day (about 108.), which includes everything. One could not desire anything better-the rooms are light, airy and cheerful-good spring mattresses on the beds, and an air of cleanliness and neatness everywhere.

The second class room costs three guldens a day, and seemed little if anything inferior to the first class.

Attached to the paying pavilions is a large cheerful room where patients can sit, if well enough to rise, while their rooms are being aired and cleansed.

We saw several women patients walking about looking cheerful and clean, and one dear little girl who seemed to be everyone's pet.

We next went to the common or third-class pavilions, common, only, inasmuch as eight persons sleep in one room, and third class simply to distinguish it from the other two classes.

Another difference is that first and second class patients may wear clothes and linen of their own providing, while the third class are obliged to wear those supplied by the hospital.

On an average, the daily cost of a bed to the hospital is three guldens, sixty kreuzers (about 58. 7d.).

No infectious case is taken here, But should any infectious disease occur among the nurses or patients while in the hospital, they are placed in an isolated pavilion reserved for such.

The matron or superintendent is a baroness, Sister of the Red Cross and devoted to her work. Both she and the doctor took us into every corner of the hospital, anxious that we should see thoroughly the working of each department.

Every six months twelve probationers are received here, learning, both by daily work in the wards and by lectures, the work of nursing. They must remain two years, at the end of which, if they pass their final examination with credit and bear a high character, they are received as Red Cross Sisters, and their badge, a brooch with a red cross, is bestowed upon them. The Red Cross Sisters hold themselves ready for private nursing in the town if required.

On leaving the wards we were taken into the washing or laundry pavilion; the most perfect we have seen anywhere, at home or abroad. All the laundry work of the hospital is done here. As many as four or five thousand pieces a week passing through the hands.

They have all the best machines for washing and rinsing-huge coppers where the linen soaks -all of which are in one immense room. Passing out of this to one on the same floor, we see the linen sorted and packed in large baskets, and a few steps leading up out of this room brings us to a small one where the drying closets, such as are to be seen in all our London hospitals, are situated.

We were called on to admire the quality of the sheets and other bed linen, which is certainly excellent.

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HOSPITAL NURSES IN LONDON AND ON THE CONTINENT.

Leaving this department we next visited the itchen which cooks for all the pavilions. The cooking is done by steam, and extremely well lone, but we were surprised to hear that no roken or left food is allowed to be given away is in our hospitals. There are six cooks.

The method of conveying the food from the kitchen to the various pavilions is admirable. It is by little covered hand-carts fitted with crays; the food reaching the patients warm and nice looking.

Of course the probationers learn the work of every department under the sisters. In every particular this may rightly be regarded as a model Red Cross hospital, and it would be worth visiting by any one interested in hospital work.

I noticed the absence of flowers and plants in the wards, and was surprised to hear from the lady superintendent that she disapproved of them altogether in hospitals. I could not help remembering how they cheered the sick in our London hospitals.

As this is the last hospital we shall see at present under the care of the Red Cross Sisters, it may not be out of place to say how thoroughly appreciated and recognised is the work performed by women under the banner of the Red Cross. How marvellously successful they are in their work of love; whether it be in taking comfort to the battle-field, performing heroic deeds by the sick bed, or in introducing order and cleanliness into the homes of the poor, one must watch them to know. May they go on nursing, saving, and strengthening the lives of the people, and using their opportunities to bring the sick to the True Physician!

THE HOSPITAL IN MILAN.

The L'Ospedale Maggiore di Milano, which stands near the church of San Nazaro in Broglio, was formerly the palace of the Sforzas, and retains many traces of its former grandeur.

It was the gift of Francesco Sforza, who expressed his wish that it should be a grand and solemn hospital, worthy of his dukedom and of the illustrious city of Milan.

It has been in existence as a hospital since 1456, and not a hospital we have visited, either at home or abroad, exceeds it in order, cleanliness, quiet and regularity.

All cases of sickness are taken in, and the size of the building may be imagined, when I say there were 2600 patients within its walls the day we were there, and that in times of epidemic they can accommodate 4000.

Large as it is, however, and notwithstanding its six branches in other parts of Milan, it is yet insufficient for the ever-increasing population.

Sixty sisters, 250 women-nurses, and 112 men are employed in the wards. There are also 115 doctors and 20 chemists.

Each ward contains sixty patients, and is under the care of one sister, four lay nurses, and one

man.

We began our inspection of the hospital by entering the "Santa Corona" department, where

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very poor people from outside, taking with them. an order from a doctor, can get medicine and advice gratis. Four to five thousand avail themselves of this free dispensary daily, and are attended to by thirty to forty medical men.

We entered the cavern-like dispensary where the chemists were busily engaged in making up and sending away the different medicines.

Leading out of this was another similar room, in the centre of which stood a row of copper cauldrons, each with the name of the concoction within written above, such as solution of arnica, so as to prevent any mistake.

In one of the side walls was a trap door, opening into the outer corridor, through which empty trays were received, and returned filled with the made-up prescriptions.

We mounted some stairs and found ourselves in the infants' ward, at the entrance of which was a porteress in a little box, whose duty it is to see that the visitors convey no food or prohibited articles to the patients whom they come to see.

Every ward in the hospital has such a porter or porteress-visitors may give oranges and lemons and grated cheese to the patients, but no meat, bread, wine, or spirituous liquors.

This rule the contadini, or country people, are always attempting to break, and they would succeed but for the vigilance of these officers at the entrance.

The children looked happy and pretty in their little white beds, which were arranged down each side and along the centre. This last was a single row, but in the larger wards a double row of beds is arranged down the middle back to back.

There was a table in this ward for small operations, the more important ones being performed in the theatre close by.

The theatre possesses a good light, an operating table, and an extra table close to it with all necessary apparatus, and a machine with tubing attached, through which water can be directed on to the patient when needed.

There are two surgical wards for women and four for men. These wards are enormous, more like churches, running the height of the hospital, and on looking upon them from above, we were astonished at their proportions. A glass screen in the centre divides them in two-formerly from their size they were too draughty.

Throughout the whole hospital the beds are excellent, and the nurses are proud of the wire mattresses.

The kitchen is a most tempting place. It is under the direction of three sisters, seven women, and four men cooks. Here the food is prepared for the sick alone, not for the sisters or

nurses.

As we entered, all were busy ladling out the soup, meat, and vegetables into various pails and pans, as carefully cooked and served as though for a private table.

There is a crane to lift the huge coppers from off the fire. Outside is an electric board which notifies how much coffee and milk mixed, and coffee alone is required.

Everything connected with the food, whether

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HOSPITAL NURSES IN LONDON AND ON THE CONTINENT.

of quantity, quality, or kind, is clearly noted down, together with the date and special patient to whom it is sent.

The dispensing of the food is entrusted to three sisters and one servant.

The time for patients' meals is eight o'clock breakfast, one o'clock dinner, and seven o'clock supper; and the doctors' visits are at seven o'clock and eight o'clock in the morning, and at half-past seven in the evening.

The laundry is fitted up with the most perfect machinery, and the whole work performed by twenty men and twenty-four women under the supervision of two sisters.

Fifteen hundred to two thousand sheets are washed every day, and the average weight of linen washed in a year is 1,934,385 kilos.

The amount of Cardiff coal used in the laundry in the year, was 2993 cwt.; of coke, 1809; of wood, 1181; of soda, 176.

The linen from the infectious wards is washed in a separate place.

All linen is found by the hospital, and is given to the poor women of Milan to make up.

We were shown into the book-keeping rooms, which greatly interested me. The books are huge and kept in a most methodical manner.

A daily register is kept of every ounce of food, whether of meat, meal, vegetable, or bread, and of every drop of drink, whether of wine, milk, coffee, or tea consumed. Each book lasts a year, and without the least difficulty one can ascertain the year's consumption.

We next went to the coach-house and saw the four carriages, or ambulances, in use. One is for fetching the sick from their homes to the hospital. It is provided with cushions, curtains, and every comfort.

A separate one, and equally comfortable, is used only to take convalescents from the hospital: a practice we thought good and prudent.

A third is for bringing and taking insane people who are received here until they can be taken to proper houses.

There is yet a fourth, which is used for infectious cases, and kept in a separate house.

Some of the patients who can afford it pay two lire a day, but are treated in no wise different to those who pay nothing, nor have they separate

rooms.

There is no department in this large hospital but bears the stamp of forethought and cleanliness, and the question naturally arises as to what is the secret of its efficiency. One need only pay a visit into every corner of it, as we did, to recognise that the skill of the doctors and the beneficent desires of the directors are followed up by the most skilful nursing and careful supervision. Nothing is too small or too insignificant to come within the range of discipline.

This and indeed nearly all the hospitals in Italy are nursed and superintended by the sisters of St. Vincent de Paul.

In consequence of the law suppressing religious orders, the existence of these sisters cannot be legally recognised-they are therefore called sorveglianti, or superintendents; but, whatever

the name, it does not alter the character of their work; and, in spite of all, they continue to be called Sisters.

Every department of the hospital, whether wards, kitchens, laundry, wardrobes, dispensaries, or clerks' offices, is under their superintendence; so also are the nurses and helpers.

The sisters and nurses are lodged in the hospital; the pay of the first is one lira fifty cents. a day (about 18. 3d.) and food, with the privilege of having it in kind or money.

The nurses, besides their board and lodging, are provided with one uniform a year, blue and white striped, and a daily wage of from sixty to ninety cents. While the probationer is on her trials she receives only thirty cents. a day.

While the nurses are in attendance upon the insane and infectious patients they have an increase of twenty cents. daily in their wage.

Although there is no definite assurance of pensions to those who work long and faithfully, yet the Council never permits such workers to go without annuities.

In 1861 a friend of the hospital, Ignazio Risnati, left all his means to this hospital, with the injunetion that it was to be applied towards augmenting the salaries of the nurses, and for rewarding good and faithful service, so as to make the pay more in accordance with the needs of life, and to give them some sign of favour in the shape of silver and bronze medals.

The ceremony of giving these rewards is one of pomp and solemnity; with the highest meda. one hundred lire are also bestowed; with each of the next three, which are simple silver medals, fifty lire are given, and with each of the four bronze medals twenty-five lire are given.

Other benefactors have since followed in his steps.

There is a large stone placed in a prominent position on which are written the names of those nurses who have fallen victims to contagion while working in the infectious wards; it is impossible to say how much the living nurses think of this.

A great point is to secure vigilance at night in the nurses whose turn it is to watch. Two sisters take it in turn the whole night through. going from ward to ward, cheering and helping the nurses and the sick alike.

Those who have seen these ladies at work must admire them; they are so skilful in assisting the sick, so thoughtful over their needs, so ready and gentle in wiping away tears, so comforting to the sorrowful; and they so entirely devote their lives without a thought of self to the inmates of those abodes of pain in which they have chosen to dwell.

Public sick nursing is a work of Christ-like love and compassion, whether it be undertaken by our hospital sisters at home, or by the Albertinerins, the Red Cross Sisters, or the Deaconesses and the Sisters of St. Vincent de Paul on the Continent. It is a work which will make the nineteenth century remembered as the one in which women found their vocation and followed it even to the sacrifice of their lives.

IF

OUR EBEN-EZERS AND OUR NAPHTALIS.

"Then Samuel took a stone, and set it between Mizpeh and Shen, and called the name of it Eben-ozer, saying, Hitherto hath the Lord helped us."-1 Samuel vii. 12.

"O Naphtali, satisfied with favour, and full with the blessing of the Lord."-Deut. xxxiii. 23.

F the setting up of this pillar memorialising the Divine help was typical of marked epochs of deliverance in the lives of God's children through all the various tracks of time, just as typical were the circumstances under which it came to be raised.

The Israelites had been in difficulties that threatened to overwhelm them, and their difficulties came upon them when it might appear that they had least reason to expect them.

Had not the ark of the Lord, for which the hearts of the fathers of the congregation trembled, been brought from Bethshemesh and placed in the jealous guardianship of Abinadab's consecrated son?

Had not the hearts of all the House of Israel been lamenting long after Him who was known to them as the great I AM, and who had promised by many a holy covenant, and by many a comfortable word spoken in the wilderness, to be a rewarder of all them that diligently seek Him?

And to the mind of these Hebrew children, whose spiritual education was yet incomplete, awaiting the fulness of the time, temporal blessings did not lie outside the circle of the Divine blessing as a kind of happy accident unworthy their desire or care; they were included within it, an inheritance for their posterity, a pledge of present favour, an earnest of better things to come.

And yet after mourning long over their sins, and lamenting after the Lord, as a child becoming conscious of loneliness cries after the fatherwhom a turn in the road has hidden from his sight-after pouring out their penitent hearts like water before God, the only effect of their gathering together seems to be that those remorseless lords of the Philistines, are swooping down upon them, and soon there will be an utter

rout.

"Oh, pray! pray!" they say unto Samuel. "Cease not to cry unto the Lord our God for us, that He will save us out of the hands of the Philistines."

The answer to prayer was to the eye of sense delayed, and yet the very circumstances that were so trying to their faith, were "working together for their good."

The on-moving Philistines came down full charge, but their war was with the elements. For battle dust and din, there was the roar of thunder, while like a destroying angel the swift forked lightning glanced hither and thither, and death and destruction were the consequences of its terrible play.

So signal was the defeat of the haughty Philistines that they came no more into the coasts of these people for whom the very heavens contended.

The extremity of the Israelites had been God's opportunity-no human help could have availed them. So they would see it looking back, and in all the joy of this fresh deliverance, Samuel took a stone, and set it between Mizpeh and Shen, and called the name of it Eben-ezer, saying, "Hitherto hath the Lord helped us."

"Hitherto." Yes, whether they looked back on as much of the past as was included in their own brief lives, or in the lives of their fathers since the time of the Exodus, they were bound to acknowledge that the Lord had helped them. Their fathers had trusted in Him, they had trusted, and were not confounded. The children also had the sanction of a very rich and varied experience.

So it is, that that emphatic pregnant word "Eben-ezer" has come down from them to us, and thousands of believers in every generation have given it their happy and thankful endorsement. Eben-ezer-the word stands above many a humble house of prayer that the contributions of the poor have raised. We have seen it cleanly-carved above the door of the modest home that thrift and the blessing of the Lord on the diligent hand had given to old age. venerable saint, nearing the end of the earthly pilgrimage, breathes it in the ear of children and of children's children. The earnest man, the timid woman entangled in the worldly snare, says it with backward look upon the past and wistful believing gaze into the future.

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Yes: hitherto hath the Lord helped us. Let us thank Him for having cared for us and kept us thus far, before we commit the perplexed present, the future behind curtains, to His care.

Never does the period draw near when the old year retires into the eternal past and the new one steps out from the eternal future, that a thousand hearts and minds are not engaged in recalling the events which the last twelve months have brought to them, that after the retrospect they may erect Eben-ezers, the full signification of which is oftentimes between themselves and God. Sicknesses cured, calamities averted, beloved wanderers brought into the fold, family breaches healed, property saved. Oh! with how many the position has seemed as desperate as it did to the Israelites when the Philistines were sweeping down upon them, but somehow deliverance came. Perhaps not so signally as to the Hebrew children, but still just as certainly.

Faith has said: "It is the Lord. He sent from above, He took me, He drew me out of many waters." We need to encourage ourselves by remembering the past, that we may go forward to meet the future. How many glance furtively with feelings of sick apprehension to the year that is coming. They dare not look it in the

face; they feel so sure that in the secret scroll it carries there are dark portents for them, and for their father's house, or for their little ones. Their hearts fail them, considering the signs of the times, depression in trade, symptoms of disease, sounds of the Philistines preparing for attack. They do not know what is written in that scroll, but they know full well what is likely to be, so far as they are concerned.

Ah! a little knowledge is a dangerous thing. Did they know all that would be before they wrote their last Eben-ezer, and Eben-ezer before that again?

If this year is like the years beyond the flood, must not Eben-ezer once more be the Finis?

Has God used up all His means of deliverance? Have we come to the end of our faith and gratitude, of our stones of help? Where the way of deliverance has been manifest to us once, has not the danger risen before us a hundred times, magnified by the mist, till it loomed upon us like a tall son of Anak, with whom we were not able to contend?

"Let us forward,” cried a voice from the deep, a voice whose dying accents were "How beautiful is God!" 1

"Let us forward: God leads us; though blind, shall we be afraid to follow? I do not see my way; I do not care to; but I know that He sees His way, and that I see Him, and I cannot believe that, in spite of all one's sins, He will forget His gracious promises."

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They looked unto Him and were lightened, and their faces were not ashamed."

Yet while we lay our hands on our stones of help, and bend our heads reverently over them, making these stones an altar for the renewal of self-dedication, does not something whisper to us of more blessed experiences, which we have coveted all too languidly, and only sought fitfully to possess?

"Eben-ezer; Hitherto hath the Lord helped us!" The word is good, but it speaks perhaps of ever-recurring pain, and need and conflict. Is our life here to be all made up of the contest with flesh and blood, and a weary world, with brief moments of exultation and occasional notes of praise? Do those of us who believe, not enter into rest, until Death has laid his cold hand on our heart's tumultuous beatings?

Like a burst of jubilant music, sweeps through the heart the memory of these words of benediction on the Patriarch's son:-"Satisfied with favour, and full with the blessing of the Lord." What must it be to be satisfied? Oh, happy Naphtali, and seven times enriched! Can such a fulness of blessing, temporal and spirtual, be the portion of any beside thee? Can the heirs of God's spiritual Israel ask for, believe for, hope for, so much except on the hither side of Jordan?

We look to be satisfied, when we behold His face in righteousness, when we "awake with His likeness," but can we, even in this cold, hard, mutable world, be "satisfied with favour"? To the law and to the testimony.

1 Rev. Canon Kingsley.

"The promise is to you and your childre says the Holy Book, and we see the verificata of it in lives that, like our own, were full of trii, in hearts that sometimes knew dismay.

"In His presence is fulness of joy,” is true d this world as well as of that which is to come. The earnest of His Spirit in our hearts L be a rich foretaste of the inheritance whic waits upon the final manifestation of the soof God; for what is the kingdom of God bu righteousness and peace, and joy in the Hey Ghost?

"Satisfied with favour." Paul the Aged makes heathen Nero welcome to his head. His soul is in other keeping; he is persuaded all is well.

And have we not had Naphtalis in our midst. of whom we may think lovingly and reverently as "satisfied with favour, and full with the blessing of the Lord?"

There are young Naphtalis to call to mind as well as aged ones; but more naturally we recal the veteran, reposing in a green old age, in the light of a glorious, setting sun.

As we write, we think upon the stately passage to the grave of one, who for many years had been an overseer of Christ's flock.

His last wish had been gratified, for he had lived to see his ninetieth year. On his eightyninth birthday his children, and his children's children, and their children again, received from his hand their tokens of his love, and felt it laid upon their heads, while words of patriarchal blessing flowed from his lips.

When a few months afterwards he was laid upon his bed of death, beatific brightness beamed upon his countenance.

"Satisfied with favour, and full with the blessing of the Lord?" enquired a friend, who had just been ushered into his presence; but he lay in a repose so deep, it was doubtful whether the words reached his consciousness.

"Shall we say of you, 'O, Naphtali, satisfied with favour?'" was repeated once again.

The dying saint instantly caught what was meant. His left hand was clenched, and his arm energetically extended upwards, and so held for several seconds, in evident reference to the exulting words spoken of all the tribes which shortly after follow: "The eternal God is Thy refuge, and underneath are the everlasting arms."

And those everlasting arms are stretched out to us, for us to cast ourselves into and be satisfied. Yes, after all the childish wailing and the long unrest and weariness with the burden which we cannot carry, but which He can carry so easily for us, while we lean it upon Him.

After the disquietude and weeping shall be the sweet hushing and the soft wiping away of tears.

We may come to the peak of our highest experiences by a very painful and difficult path, but His leading will surely bring us to it.

Let the weak in faith, the almost despairing take to heart these words also of a voice that spoke out of the deep, and they will learn how the healing, and rest, and full heart-satisfaction may come.

"Art thou robbed, wounded, deserted, left to die, worsted in the battle of life, and fallen in its

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