In Wards which are too close, it has been found that
one or two square Holes (of about six or eight, or ten Inches
diameter), cut in the Cieling, and a Tube made of Wood fitted
to it, and carried up into the Chimney of the Ward above, so
as to enter above the Grate, is one of the best Contrivances
for procuring a free Circulation of Air; as the foul Air,
which is lightest, and occupies the highest Part of the Ward,
finds a free Exit by these Tubes: We have such Tubes now
fixed in several of the Wards in _St. George_'s Hospital. A
Hole cut above the Door of the Ward, or in the upper Part of
the Windows, and one of what are called the _Chamber
Ventilators_ fixed in it, will answer, where Holes cannot be
conveniently cut in the Cieling.

In Winter, Fires should be lighted in all the Wards where it can be
done.

In foreign Countries, when we meet with Hospitals where there are no
Places for open Fires, but only close Stoves, different Contrivances
may be used to renew the Air. Ventilators of different Kinds may be
used, or Openings made in the Doors and Windows. In Winter 1761-62,
some of the Wards in the Hospital at _Bremen_ which I attended had
such Stoves. In order to keep up a free Circulation of Air in those
Wards, I directed large Holes to be cut in the lower Part of the Door
in each Ward, and two Grooves to be made on the Outside of the Door,
above and below the Hole, parallel to each other, in which a Board
slided; by means of which, the Hole could be either quite covered or
only in Part, or left entirely open; and I directed a Casement, about
eight or nine Inches square, to be made in the upper Corner of each
Window. After the Fires were lighted, upon removing the Board which
covered the Hole in the Door, and opening the little square Windows, a
Current of fresh cool Air rushed into the Ward by the Door, while the
heated foul Air found an Exit by the Windows. In very cold Weather,
the Opening of the small Windows was sufficient; but in mild Weather,
and in Summer, it was necessary to keep both open.

The Wards should be daily fumigated by Means of Aromatics, or wetted
Gunpowder thrown on burning Coals, put in an Iron Pot or Chaffern, or
with the Steams of warm Vinegar placed in the Middle of the Ward. Dr.
_Lind_ says, that although Cleanliness and a pure Air contribute much
to prevent infectious Disorders, or to check them, yet that they of
themselves are not alwa