ample windows to open, and these are
never opened to get rid of the smell of paint, it is a proof of want of
management in using the means of ventilation. Of course the smell will
then remain for months. Why should it go?

[2]
[Sidenote: Why let your patient ever be surprised?]

Why should you let your patient ever be surprised, except by thieves? I
do not know. In England, people do not come down the chimney, or through
the window, unless they are thieves. They come in by the door, and
somebody must open the door to them. The "somebody" charged with opening
the door is one of two, three, or at most four persons. Why cannot
these, at most, four persons be put in charge as to what is to be done
when there is a ring at the door-bell?

The sentry at a post is changed much oftener than any servant at a
private house or institution can possibly be. But what should we think
of such an excuse as this: that the enemy had entered such a post
because A and not B had been on guard? Yet I have constantly heard such
an excuse made in the private house or institution, and accepted: viz.,
that such a person had been "let in" or _not_ "let in," and such a
parcel had been wrongly delivered or lost because A and not B had opened
the door!

[3]
There are many physical operations where _coeteris paribus_ the danger
is in a direct ratio to the time the operation lasts; and _coeteris
paribus_ the operator's success will be in direct ratio to his
quickness. Now there are many mental operations where exactly the same
rule holds good with the sick; _coeteris paribus_ their capability of
bearing such operations depends directly on the quickness, _without
hurry_, with which they can be got through.

[4]
[Sidenote: Petty management better understood in institutions than in
private houses.]

So true is this that I could mention two cases of women of very high
position, both of whom died in the same way of the consequences of a
surgical operation. And in both cases, I was told by the highest
authority that the fatal result would not have happened in a London
hospital.

[Sidenote: What institutions are the exception?]

But, as far as regards the art of petty management in hospitals, all the
military hospitals I know must be excluded. Upon my own experience I
stand, and I solemnly declare that I have seen or known of fatal
accidents, such as suicides in _delirium tremens,_ bleedings to death,
dying patients dragged out of bed by drunken