Chapter X: Part II: The Practice of Horticulture (8)

HOSHEA (Heb. for "deliverance"), the last king of Israel, in the Bible. The attempt of his predecessor Pekah to take Jerusalem with the help of his ally Rasun (Rezin) of Damascus was frustrated by the intervention of Tiglath-Pileser IV. (see AHAZ), who attacked Gilead, Galilee and the north frontier, and carried off some of its population (cp. 1 Chron. v. 26). Pekah's resistance to Assyria led to a conspiracy in which he lost his life, and Hoshea the son of Elah became king (2 Kings xv. 27-30). The Assyrian king held him as his vassal (and indeed claims to have set him on the throne), and exacted from him a yearly tribute. Meanwhile, Damascus was besieged (733-732 B.C.), Rasun was slain and the inhabitants deported (2 Kings xvi. 9; LXX. omits "to Kir," but see Amos i. 5). The impending fate of Damascus is illustrated by Isaiah (vii. 16, viii. 4, xvii. 1-11), who also gives a vivid description of the impression left by the Assyrian army (v. 26-30). After the death of Tiglath-Pileser, Israel regained confidence (Isa. ix. 8-x. 4) and took steps to recover its independence. Its policy vacillated--"like a silly dove" (Hos. vii. 11), and at length negotiations were opened with Mizraim. The annual payment of tribute ceased and Shalmaneser IV. (who began to reign in 727 B.C.) at once laid siege to Samaria, which fell at the end of three years (722-721 B.C.). The achievement is claimed by his successor Sargon. Hoshea was killed, the land was again partly depopulated and a governor appointed (2 Kings xviii. 9-12; cp. xvii. 1 sqq.). For other allusions to this period see HOSEA, ISAIAH.

2 Kings xvii. 3 and 5 imply _two_ attacks by Shalmaneser: in the first
of which Hoshea was imprisoned and perhaps blinded (Cheyne, emending,
"shut him up" in v. 4), although in v. 6 he is still reigning; see on
this Winckler, _Keilinschr. u. Alte Test._^3 p. 268; Burney, _Kings_,
p. 328 seq.; Skinner, _Kings_, p. 372 seq. The chronological notes,
moreover, are extremely confused; contrast xv. 30 with xvii. 1. The
usual identification of So (or Seve), king of Mizraim, with Shabaka of
Egypt is difficult, partly on chronological grounds (which Petrie,
_History of Egypt_, pp. 277, 281 sqq. does not remove), and partly
because the Ethiopian dominion in Egypt appears to be still weak and
divided. The Assyrian records name a certain Sibi as _officer_, and
also Piru (Pharaoh!) as _king_ of Musri, and it is doubtful whether
Hoshea's ally was a petty prince of Egypt or of a N. Arabian district
(see MIZRAIM). If the latter, Hoshea's policy becomes more
intelligible; see Whitehouse, _Isaiah_, p. 17 seq.; JEWS: _History_;
PHILISTINES. On the depopulation of Samaria and the introduction of
colonists, see Winckler's objections, _Alttest. Untersuch._ pp.
95-107, with Burney's criticisms, _Kings_, p. 334 seq. (S. A. C.)

HOSHIARPUR, a town of British India, in the Jullundur division of the Punjab. Pop. (1901), 17,549. It was founded, according to tradition, about the early part of the 14th century. In 1809 it was occupied by Ranjit Singh. The maharaja and his successors maintained a considerable cantonment 1 m. S.E. of the town, and the British government kept it up for several years after the annexation of the Punjab in 1849. There are manufactures of cotton goods, inlaid woodwork, lacquered ware, shoes and copper vessels.

The DISTRICT OF HOSHIARPUR comprises an area of 2244 sq. m.; pop. (1901) 989,782, showing a decrease of 2% in the decade, compared with an increase of 12% during the previous decade. It falls into two nearly equal portions of hill and plain country. Its eastern face consists of the westward slope of the Solar Singhi Hills; parallel with that ridge, a line of lower heights belonging to the Siwalik range traverses the district from south to north, while between the two chains stretches a valley of uneven width, known as the Jaswan Dun. Its upper portion is crossed by the Sohan torrent, while the Sutlej sweeps into its lower end through a break in the hills, and flows in a southerly direction till it turns the flank of the central range, and debouches westwards upon the plains. This western plain consists of alluvial formation, with a general westerly slope owing to the deposit of silt from the mountain torrents in the sub-montane tract. The Beas has a fringe of lowland, open to moderate but not excessive inundations, and considered very fertile. A considerable area is covered by government woodlands, under the care of the forest department. Rice is largely grown, in the marshy flats along the banks of the Beas. Several religious fairs are held, at Anandpur, Mukerian and Chintpurni, all of which attract an enormous concourse of people. The district, owing to its proximity to the hills, possesses a comparatively cool and humid climate. Cotton fabrics are manufactured, and sugar, rice and other grains, tobacco and indigo are among the exports.

The country around Hoshiarpur formed part of the old Hindu kingdom of Katoch In Jullundur. The state was eventually broken up, and the present district was divided between the rajas of Ditarpur and Jaswan. They retained undisturbed possession of their territories until 1759, when the rising Sikh chieftains commenced a series of encroachments upon the hill tracts. In 1815 the aggressive maharaja, Ranjit Singh, forced the ruler of Jaswan to resign his territories in exchange for an estate on feudal tenure; three years later the raja of Ditarpur met with similar treatment. By the close of the year 1818 the whole country from the Sutlej to the Beas had come under the government of Lahore, and after the first Sikh war in 1846 passed to the British government. The deposed rajas of Ditarpur and Jaswan received cash pensions from the new rulers, but expressed bitter disappointment at not being restored to their former sovereign position. Accordingly the outbreak of the second Sikh war, in 1848 found the disaffected chieftains ready for rebellion. They organized a revolt, but the two rajas and the other ringleaders were captured, and their estates confiscated.

HOSIERY, a term used to designate all manufactured textile fabrics which in their process of manufacture have been built on the principle of looping or loop structure. The origin of the term is obvious, being derived from "hose" or stocking, this being one of the earliest garments made by the process of knitting (q.v.). While it still forms one of the staples of the trade, it is only one of a very numerous and diversified range of applications of the entire industry. The elastic structure of knitting makes it very adaptable for all kinds of body or underwear. There is scarcely a single textile article manufactured but can be reproduced on the knitting or loop structure principle. The art of knitting is of very modern origin as compared with that of weaving. No certain allusion to the art occurs before the beginning of the 15th century. In an act of parliament of Henry VII. (1488) knitted woollen caps are mentioned. It is supposed that the art was first practised in Scotland, and thence carried into England, and that caps were made by knitting for some period before the more difficult feat of stocking-making was attempted. In an act of Edward VI. (1553) "knitte hose, knitte peticotes, knitte gloves and knitte sleeves" are enumerated, and the trade of hosiers, among others, included in an act dated 1563. Spanish silk stockings were worn on rare occasions by Henry VIII., and the same much-prized articles are also mentioned in connexion with the wardrobe of Edward VI.

Knitting, or loop formation by mechanical means, is divided into two distinct principles--frame-work knitting and warp knitting. Both principles may be employed in the formation of a large variety of plain and fancy stitches or a combination of the two.

_Frame-work Knitting_ in its simplest form consists of rows of loops
supporting each other--built from one continuous thread of yarn and
running from one side of the fabric to the other and back (fig. 1). It
is on this principle of stitch that the greatest amount of hosiery is
built (hose, shirts, pants).

_Warp Knitting_ in its simplest form consists of rows of loops, but
the number of threads employed are equal to the number of loops in the
width of the fabric. Thus it will be seen that the threads run
lengthwise of the fabric (fig. 2). This principle gives greater scope
for reproducing designs in openwork and colour than that of
frame-work knitting. For this reason it is largely used in the shawl,
glove and fancy hosiery industries.

_Machinery._--In hand knitting the implements employed (a few needles
or wires) are very simple and inexpensive. In the manufacturing
industry the most complex and ingenious machinery is used. In 1589 the
Rev. William Lee, a graduate of St John's College, Cambridge, while
acting as curate (or vicar) of Calverton, Nottinghamshire, introduced
his stocking-frame. This machine was the first mechanical means
employed to produce a looped or knitted fabric. This frame or machine
of Lee's was the origin of all the hosiery and lace machines at
present in use. One of the most remarkable points about his invention
was its completeness and adaptability for the work for which its
inventor intended it. The main principles of Lee's frame are embodied
in most of the rotary or power frames of the present day. Fig. 3 shows
a hand frame of the present day.

A, The leads into which the needles (B) are cast.
D, The old loops or work.
C, The new loops formed and brought under the beards.]

In hand knitting an indefinite number of loops are skewered on a wire
or pin, but, in Lee's frame, an individual hooked or bearded needle is
employed for the support and formation of each loop in the breadth of
the fabric. This needle consists of a shank with a terminal
spring-pointed hook (or beard), the point of which can be pressed at
will into a groove or eye in the shank. For method by which the loops
are formed on the needles of the frame see fig. 4. This shows a few of
Lee's hooked or bearded needles having the old loops or work hanging
round the needle shanks. The thread of yarn which is to form the new
row of loops is laid over the needle shanks and waved or looped
between each pair of needles. This waving or looping ensures
sufficient yarn being drawn and loops of a uniform size being made, so
that a regular and level fabric will be produced. The looping or
waving is obtained by having thin plates of shaped metal, called
sinkers, which have a nose-shaped point and hang between the needles.
When looping they have an individual movement downwards between the
needles, and as they fall the nose-shaped point carries the yarn down,
thus forming the new loop (fig. 5). The size of the loop is regulated
by the distance the sinker is allowed to fall. After the thread of
yarn has been looped between the needle shanks by the sinkers, the
loops are brought forward under the needle beards or hooks. A presser
bar is now brought down to close or press all the points of the needle
beards into the eye in the shank. Thus all the hook ends of the
needles are temporarily closed, with the newly formed loops under
them. While in this position, the old loops hanging round the shank
are brought forward and landed on to the top of the needle beard and
off the needle altogether, being thus left hanging round, or supported
by the loops newly formed. The needle beards are now released, and the
loops drawn back along the shanks to be in position for next new
course of loops. The foregoing is only an outline of how the loops are
formed on the needles. It is not necessary here to enter into a
description of the complex mechanical movements of Lee's
stocking-frame. The first fabric made by Lee was of a flat,
even-selvedged nature, so that garments had to be cut to shape from
the fabric. He soon learned to fashion or shape the garment at will,
during the process of making, by transferring loops at the edges,
inwards to narrow, or outwards to widen. This process at the present
day is known as fashioning, and all garments of the best make are
shaped or fashioned in this manner. After Lee had practised his new
art for a few years at Calverton he removed to London, but on his
receiving no help or encouragement from Queen Elizabeth or her
successor, King James, he was induced to cross over to France with his
frames. There he built up a flourishing industry at Rouen, under the
patronage of the French king, Henry IV. Through the murder of this
monarch he lost his patronage and died of want about the year 1610. He
was buried in an unknown grave in Paris.

1, Bearded needle cast in the lead. A, Lead; B, Shank; C, Eye; D,
Beard.
2, The thread is laid over the needles and formed into loops between
the needles by means of the sinkers, those new-formed loops being
brought under the needle beards (as at 3).
4, The beards pressed or closed to allow the old loops to be passed
on to the top.
5, The old loops knocked off the needles and left hanging round the
newly formed loops.]

A number of improvements had been made on Lee's frame during the 18th
century. The one of greatest importance was the rib machine invented
by Jedediah Strutt of Belper in 1758. It was not what could be
actually termed an improvement on Lee's frame, but an addition to it.
Lee's frame was not altered in any way, Strutt's machine being added
to it, and the two being worked in conjunction produced a fabric of a
more elastic nature and alike on both sides (fig. 6). Strutt's machine
consisted of a set of needles placed at right angles to and between
Lee's plain needles, with the result that, when knitting, the frame
needles drew their loops to one side and the machine needles their
loops to the opposite side of the fabric. The first offshoot from
frame-work knitting was the invention of the hand warp loom in 1775.
It was improved by the addition of the Dawson wheel by William Dawson
in 1791. This machine is the origin of the various complex machines
now working on this principle. Some of these have Jacquard mechanism
attached, and nearly all of them are driven by motive power. About the
middle of the 19th century close on 50,000 of Lee's hand frames were
in use, finding employment for nearly 100,000 persons. Many attempts
had been made previously to transform Lee's frame into a power or
rotary frame. One of the first and most successful was that invented
by Luke Barton in 1857. This frame was fitted with self-acting
mechanism for fashioning, and was practically Lee's frame having
rotary shafts with cams added to give the various movements, this type
of frame being known as straight bar rotary frames. In 1864 William
Cotton of Loughborough altered this frame by reversing the positions
of the needles and sinkers. Although made by various builders it is
still known as the "Cotton Patent Rotary Frame" (fig. 7). Since 1864 a
great number of important improvements and additions have been made to
this frame. Single frames are built which will turn off one dozen
pairs of hose at once, with the attention of one person. One of the
most important inventions in connexion with the hosiery trade was the
latch, tumbler, or self-acting needle invented by Matthew Townsend and
David Moulding of Leicester in 1858. Previous to this Lee's type of
needle was the only one in use. This latch-needle (fig. 8) consists of
a stem having a butt at lower end by which it receives its knitting
action from cams, the upper end being turned into a hook. Near the
hook end and attached to the stem by a pin is the spoon-shaped latch,
which closes over the hook as required. Machines fitted with
latch-needles have grooves in which the stem of the needle works.
Cams, which act on the needle butts, give the needles their individual
knitting action in rotation. This needle is self-acting, in that it is
made to draw its own loop, sinkers being dispensed with.

Fig. 9 shows the looping action of this needle. The needles when not
knitting have a loop round their shank, thus holding the latch open.
When about to knit, they are raised individually and in rotation (by
the cams acting on the needle butts) to receive the new loop of yarn.

Down till almost the middle of the 19th century only a flat web could
be knitted in the machines in use, and for the finishing of stockings,
&c., it was necessary to seam up the selvedges of web shaped on the
frame (fashioned work), or to cut and seam them from even web (cut
work). The introduction of any device by which seamless garments could
be fabricated was obviously a great desideratum, and it is a singular
fact that a machine capable of doing this was patented in 1816 by Sir
Marc I. Brunel. This frame was the origin of the French-German
loop-wheel circular frame of the present day. Brunel's frame was
greatly improved by Peter Claussen of Brussels and was shown at an
exhibition in Nottingham in 1845. This frame had horizontal placed
needles fixed on a rotating rim. A few years later Moses Mellor of
Nottingham transformed this type of frame by altering the position of
the needles to perpendicular. This is now known as the English
loop-wheel circular frame. After the invention of the latch-needle
there was a revolution in the hosiery machine-building industry, new
types of machines being invented, fitted to work with latch-needles.
Among others there was the latch-needle circular frame, invented by
Thomas Thompson, which was the origin of the English latch-needle
circular frame, a frame largely used for the production of wide
circular fabric.

A circular knitting machine of American origin is the type of machine
on which is produced the seamless hosiery of to-day. Like the sewing
machine it is largely used in the home as well as in the factory. From
this machine all the circular automatic power machines for making
plain and rib seamless hose and half hose have been developed. The
"flat" or "lamb" type of machine, an American invention, was
introduced by J. W. Lamb in 1863. This machine has two needle beds or
rows of needles sloping at an angle of nearly 90 deg.

A great many varieties of this type of machine have been invented for
the production of all kinds of plain and fancy hosiery. It is built in
small sizes to be wrought by hand or in large power machines. A large
variety of sewing, seaming and linking machines are employed in the
hosiery industry for the purpose of putting together or joining all
kinds of hosiery and knitted goods. These machines have almost
entirely superseded the sewing or joining of the garments by hand.

The principle centres in Great Britain of the hosiery industry are
Leicester and Nottingham and the surrounding districts. It is also an
industry of some extent in the south of Scotland. (T. B.*)

HOSIUS, or OSIUS (c. 257-359), bishop of Cordova, was born about A.D. 257, probably at Cordova, although from a passage in Zosimus it has sometimes been conjectured that he was believed by that writer to be a native of Egypt. Elected to the see of Cordova before the end of the 3rd century, he narrowly escaped martyrdom in the persecution of Maximian (303-305). In 305 or 306 he attended the council of Illiberis or Elvira (his name appearing second in the list of those present), and upheld its severe canons concerning such points of discipline as the treatment of the lapsed and clerical marriages. In 313 he appears at the court of Constantine, being expressly mentioned by name in a constitution directed by the emperor to Caecilianus of Carthage in that year. In 323 he was the bearer and possibly the writer of Constantine's letter to Bishop Alexander of Alexandria and Arius his deacon, bidding them cease disturbing the peace of the church; and, on the failure of the negotiations in Egypt, it was doubtless with the active concurrence of Hosius that the council of Nicaea was convened in 325. He certainly took part in its proceedings, and was one of the large number of "confessors" present; that he presided is a very doubtful assertion, as also that he was the principal author of the Nicene Creed. Still he powerfully influenced the judgment of the emperor in favour of the orthodox party. After a period of quiet life in his own diocese, Hosius presided in 343 at the fruitless synod of Sardica, which showed itself so hostile to Arianism; and afterwards he spoke and wrote in favour of Athanasius in such a way as to bring upon himself a sentence of banishment to Sirmium (355). From his exile he wrote to Constantius II. his only extant composition, a letter not unjustly characterized by the great French historian Sebastian Tillemont as displaying gravity, dignity, gentleness, wisdom, generosity and in fact all the qualities of a great soul and a great bishop. Subjected to continual pressure the old man, who was near his hundredth year, was weak enough to sign the formula adopted by the second synod of Sirmium in 357, which involved communion with the Arians but not the condemnation of Athanasius. He was then permitted to return to his diocese, where he died in 359.

See S. Tillemont, _Memoires_, vii. 300-321 (1700); Hefele,
_Conciliengeschichte_, vol. i.; H. M. Gwatkin, _Studies of Arianism_
(Cambridge, 1882, 2nd ed., 1900); A. W. W. Dale, _The Synod of Elvira_
(London, 1882); and article _s.v._ in Herzog-Hauck, _Realencyklopadie_
(3rd ed., 1900), with bibliography.

HOSIUS, STANISLAUS (1504-1579), Polish cardinal, was born in Cracow on the 5th of May 1504. He studied law at Padua and Bologna, and entering the church became in 1549 bishop of Kulm, in 1551 bishop of Ermland, and in 1561 cardinal. Hosius had Jesuit sympathies and actively opposed the Protestant reformation, going so far as to desire a repetition of the St Bartholomew massacre in Poland. Apart from its being "the property of the Roman Church," he regarded the Bible as having no more worth than the fables of Aesop. Hosius was not distinguished as a theologian, though he drew up the _Confessio fidei christiana catholica_ adopted by the synod of Piotrkow in 1557. He was, however, supreme as a diplomatist and administrator. Besides carrying through many difficult negotiations, he founded the lyceum of Braunsberg, which became the centre of the Roman Catholic mission among Protestants. He died at Capranica near Rome on the 5th of August 1579.

A collected edition of his works was published at Cologne in 1584.
Life by A. Eichhorn (Mainz, 1854), 2 vols.

HOSKINS, JOHN (d. 1664), English miniature painter, the uncle of Samuel Cooper, who received his artistic education in Hoskins's house. His finest miniatures are at Ham House, Montagu House, Windsor Castle, Amsterdam and in the Pierpont Morgan collection. Vertue stated that Hoskins had a son, and Redgrave added that the son painted a portrait of James II. in 1686 and was paid L10, 5s, although it is not supported by any reference in the State Papers. Some contemporary inscriptions on the miniatures at Ham House record them as the work of "Old Hoskins," but the fact of the existence of a younger artist of the same name is settled by a miniature in the Pierpont Morgan collection, signed by Hoskins, and bearing an authentic engraved inscription on its contemporary frame to the effect that it represents the duke of Berwick at the age of twenty-nine in 1700. The elder Hoskins was buried on the 22nd of February 1664, in St Paul's, Covent Garden, and as there is no doubt of the authenticity of this miniature or of the signature upon it, it is evident that he had a son who survived him thirty-six years and whose monogram we find upon this portrait. The frame of it has also the royal coat of arms debruised, the batons of a marshal of France, the collar of the Golden Fleece and the ducal coronet. (G. C. W.)

HOSMER, HARRIET GOODHUE (1830-1908), American sculptor, was born at Watertown, Massachussetts, on the 9th of October 1830. She early showed marked aptitude for modelling, and studied anatomy with her father, a physician, and afterwards at the St Louis Medical College. She then studied in Boston until 1852, when, with her friend Charlotte Cushman, she went to Rome, where from 1853 to 1860 she was the pupil of the English sculptor John Gibson. She lived in Rome until a few years before her death. There she was associated with Nathaniel Hawthorne, Thorwaldsen, Flaxman, Thackeray, George Eliot and George Sand; and she was frequently the guest of the Brownings at Casa Guidi, in Florence. Among her works are "Daphne" and "Medusa," ideal heads (1853); "Puck" (1855), a spirited and graceful conception which she copied for the prince of Wales, the duke of Hamilton and others; "Oenone" (1855), her first life-sized figure, now in the St Louis Museum of Fine Arts; "Beatrice Cenci" (1857), for the Mercantile Library of St Louis; "Zenobia, Queen of Palmyra, in Chains" (1859), now in the Metropolitan Museum of Art, New York City; "A Sleeping Faun" (1867); "A Waking Faun"; a bronze statue of Thomas H. Benton (1868) for Lafayette Park, St Louis; bronze gates for the earl of Brownlow's art gallery at Ashridge Hall; a Siren fountain for Lady Marian Alford; a fountain for Central Park, New York City; a monument to Abraham Lincoln; and, for the Columbian Exposition, Chicago, 1893, statues of the queen of Naples as the "heroine of Gaeta," and of Queen Isabella of Spain. Miss Hosmer died at Watertown, Mass., on the 21st of February 1908.

HOSPICE (Lat. _hospitium_, entertainment, hospitality, inn, _hospes_, host), the name usually given to the homes of rest and refuge kept by religious houses for pilgrims and guests. The most famous hospices are those of the Great and Little St Bernard Passes in the Alps.

HOSPITAL (Lat. _hospitalis_, the adjective of _hospes_, host or guest), a term now in general use for institutions in which medical treatment is given to the sick or injured. The place where a guest was received, was in Lat. _hospitium_ (Fr. _hospice_), but the terms _hospitalis_ (sc. _domus_), _hospitale_ (sc. _cubiculum_) and _hospitalia_ (sc. _cubicula_) came into use in the same sense. Hence were derived on the one hand the Fr. _hospital_, _hopital_, applied to establishments for temporary occupation by the sick for the purpose of medical treatment, and _hospice_ to places for permanent occupation by the poor, infirm, incurable or insane; on the other, the form _hotel_, which became restricted (except in the ease of _hotel-Dieu_) to private or public dwelling-houses for ordinary occupation. In English, while "hostel" retained the earlier sense and "hotel" has become confined to that of a superior inn (q.v.), "hospital" was used both in the sense of a permanent retreat for the poor infirm or for the insane, and also for a regular institution for the temporary reception of sick cases; but modern usage has gradually restricted it mainly to the latter, other words, such as almshouse and asylum, being preferred in the former cases.

_The Origin of Hospitals._--In spite of contrary opinions the germ of the hospital system may be seen in pre-Christian times (see CHARITY AND CHARITIES). Pinel goes so far as to declare that there were asylums distinctly set apart for the insane in the temples of Saturn in ancient Egypt. But this is probably an exaggeration, the real historical facts pointing to the existence of medical schools in connexion with the temples generally, to the knowledge that the priests possessed what medical science existed, and finally to the rite of "Incubation," which involved the visit of sick persons to the temple, in the shade of which they slept, that the god might inform them by dreams of the treatment they ought to follow. The temples of Saturn are known to have existed some 4000 years before Christ; and that those temples were medical schools in their earliest form is beyond question. The reason why no records of these temples have survived is due to the fact that they were destroyed in a religious revolution which swept away the very name of Saturn from the monuments in the country. Professor Georg Ebers of Leipzig, whose possession of that important handbook of Egyptian medicine called the _Papyrus Ebers_ constitutes him an authority, says the Heliopolis certainly had a clinic united to the temple. The temples of Dendera, Thebes and Memphis, are other examples. Those early medical works, the Books of Hermes, were preserved in the shrines. Patients coming to them paid contributions to the priests. The most famous temples in Greece for the cure of disease were those of Aesculapius at Cos and Trikka, while others at Rhodes, Cnidus, Pergamum and Epidaurus were less known but frequented. Thus it is clear that both in Egypt and in Greece the custom of laying the sick in the precincts of the temples was a national practice.

Alexandria again was a famous medical centre. Before describing the European growth of the hospital system in modern times, to which its development in the Roman Empire is the natural introduction, it will be well to dispose very briefly of the facts relating to the hospital system in the East. Harun al-Rashid (A.D. 763-809) attached a college to every mosque, and to that again a hospital. He placed at Bagdad an asylum for the insane open to all believers; and there was a large number of public infirmaries for the sick without payment in that city. Benjamin, the Jewish traveller, notes an efficient scheme for the reception of the sick in A.D. 1173, which had long been in existence. The Buddhists no less than the Mahommedans had their hospitals, and as early as 260 B.C. the emperor Asoka founded the many hospitals of which Hindustan could then boast. The one at Surat, made famous by travellers, and considered to have been built under the emperor's second edict, is still in existence. These hospitals contained provision so extensive as to be quite comparable to modern institutions. In China the only records that remain are those of books of very early date dealing with the theory of medicine. To return to India, the hospitals of Asoka were swept away by a revival of Brahmanism, and a practical hiatus exists between the hospitals he introduced and those that were refounded by the British ascendancy. Hadrian's reign contains the first notice of a military hospital in Rome. At the beginning of the Christian era we hear of the existence of open surgeries (of various price and reputation), the specialization of the medical profession, and the presence of women practitioners, often as obstetricians. Iatria, or _tabernae-medicae_, are described by Galen and Placetus: many towns built them at their own cost. These iatria attended almost entirely to out-patients, and the system of medicine fostered by them continued without much development down to the middle of the 18th century. It is to be noted that these out-patients paid reasonable fees. In Christian days no establishments were founded for the relief of the sick till the time of Constantine. A law of Justinian referring to various institutions connected with the church mentions among them the Nosocomia, which correspond to our idea of hospitals. In A.D. 370 Basil had one built for lepers at Caesarea. St Chrysostom founded a hospital at Constantinople. At Alexandria an order of 600 Parabolani attended to the sick, being chosen for the purpose for their experience by the prelate of the city (A.D. 416). Fabiola, a rich Roman lady, founded the first hospital at Rome possessed of a convalescent home in the country. She even became a nurse herself. St Augustine founded one at his see of Hippo. These Nosocomia fell indeed almost entirely into the hands of the church, which supported them by its revenues when necessary and controlled their administration. Salerno became famous as a school of medicine; its rosiest days were between A.D. 1000 and 1050. Frederick II. prescribed the course for students there, and founded a rival school at Naples. At this period the connexion between monasteries and hospitals becomes a marked one. The crusaders also created another bond between the church and hospital development, as the route they traversed was marked by such foundations. Lepers were some of the earliest patients for whom a specialized treatment was recognized, and in 1118 a leprosarium was built in London for isolation purposes. Russia seems the one country where the interconnexion of hospital and monastery was not to be observed. After the period already reached, the 13th century, hospitals became common enough to demand individual or at any rate national treatment.

_History of the Hospital Movement._--We have now to consider the principles upon which the provision of the best form of medical care in hospitals can be secured for all classes of people. Though hospitals cannot be claimed as a direct result of Christianity, no doubt it softened the relations between men, and gradually tended to instil humanitarian views and to make them popular with the civilized peoples of the world. These principles, as civilization grew, education improved, and the tastes and requirements of the common people were developed, made men and women of many races realize that the treatment of disease in buildings set apart exclusively for the care of the sick was, in fact, a necessity in urban districts. The establishment of a hospital freed the streets of the abuses attendant upon beggars and other poor creatures, who made their ailments the chief ground of appeal for alms. As the knowledge of hygiene and of the doctrine of cleanliness and purity in regard not only to dwellings and towns, but also in relation to food of all descriptions, including water, became known and appreciated, hospitals were found to be of even greater importance, if that is possible, to the healthy in crowded communities, than to the sick. It took many centuries before sound hygiene really began to occupy the position of importance which it is now known to possess, not only in regard to the treatment and cure of disease, but to its prevention and eradication. So the history of the world shows, that, whereas a few of the larger towns in most countries contained hospitals of sorts, up to and including the middle ages, it was not until the commencement of the 18th century that inhabitants of important but relatively small towns of from 50,000 to 100,000 inhabitants began to provide themselves with a hospital for the care of the sick. Thus, twenty-three of the principal English counties appear to have had no general hospital prior to 1710, while London itself at that date, so far as the relief of the sick was concerned, was mainly, if not entirely, dependent upon St Bartholomew's and St Thomas's Hospitals. These facts are interesting to note, because we are enabled from them to deduce from recent events that hospital buildings in the past, though the planning of most of them was faulty to begin with and became more and more faulty as extensions were added to the original buildings, did in fact suffice to satisfy the requirements of the medical profession for nearly two centuries. In other words, under the old condition of affairs the life of a building devoted to the care of the sick might be considered as at least 150 years. To-day, under the conditions which modern science impose upon the management, probably few hospital buildings are likely to be regarded as efficient for the purpose of treating the sick for more than from 30 to 50 years.

The foregoing statement is based upon the history of British hospitals of importance throughout the country, but the same remark will apply in practice to hospital buildings almost everywhere throughout the world. In truth, hospitals have been more developed and improved in Great Britain than in other countries, though, since the last quarter of the 19th century, German scientists especially have added much to the efficiency of the accommodation for the sick, not only at hospitals but in private clinics, and many German ideas have been accepted and copied by other countries. In Great Britain hospitals for the treatment of general and special diseases are mainly maintained upon what is known as the voluntary system. On the European continent, hospitals as a rule are maintained by the state or municipalities, and this system is so fully developed in Sweden and elsewhere that a sound economical principle has been embroidered upon the hospital system, to the great physical and moral advantage of all classes of the community. The system referred to confers great benefits upon inhabitants in large towns by bringing the poor-law and voluntary institutions into more intimate association, although they may be managed by separate governing bodies. The plan pursued is to demand payment from all patients who are admitted to the hospital under a scale of charges divided into three or four grades. The first grade pays a substantial sum and obtains anything or everything the patient may care to have or to pay for, subject to the control of the medical attendant. The second pays much less, but a remunerative rate, for all they receive at the hospital; and the third and fourth classes are very poor people or paupers, who are paid for on a graduated scale by the poor-law authorities, or the communal government, or the municipality. Under this system well-to-do thrifty artisans and improvident paupers are all treated by one staff, controlled by one administration, and are located in immediate proximity to each other though in separate pavilions. We have no doubt, as the result of many years' investigation and an accurate knowledge of the working of the system, that this is the true principle to enforce in providing adequate medical relief for large urban populations everywhere throughout the world. It should be accompanied by a system of government insurance, whereby all classes who desire to be thrifty may pay a small annual premium in the days of health, and secure adequate hospital treatment and care when ill. Provided that pay wings were added to the existing voluntary and municipal hospitals, it should be found that the relatively small annual premium of L3 per annum should enable the policyholders to defray the cost of medical treatment in a pay ward or at a consultation department of a great hospital as a matter of business. In the United States of America most large towns have great hospitals, usually known as city hospitals, administered and mainly supported by the municipality. Many such institutions have pay wards, but nowhere, so far as we have been able to discover, has the system of medical relief in its entirety been organized as yet upon the business system we have just referred to.

As to the relative merits and demerits of the systems of government of municipal hospitals and voluntary hospitals a few words may be useful. There can be no doubt that the voluntary hospital in Great Britain has had a remarkable effect for good upon all classes in the making of modern England. The management of these institutions is frequently representative of all classes of the people, while the voluntary system, as the Hospital Sunday collections all over the country, and all over the English-speaking world, prove, has united all creeds in the good work of caring and providing for the sick and injured members of each community. Again the voluntary system makes for efficiency in the administration of all hospitals. Each voluntary hospital is dependent upon its popularity and efficiency, in large measure, for the financial support it receives. In this way an ill-managed voluntary hospital, or one which has ceased to fulfil any useful public purpose, is sure to disappear in due course under the voluntary system. Voluntary hospitals are always open to, as well as supported by, the public, and, owing largely to the example so prominently set by King Edward VII. and members of the royal family, more people every year devote some time in some way to the cause of the hospitals. Attached to the voluntary hospitals are the principal medical and nursing schools upon which the public depend for the supply of doctors and nurses. The education of students and nurses in a clinical hospital makes that hospital the most desirable place for everybody when they are really ill. In such a hospital no patient can be overlooked, no wrong or imperfect diagnosis can long remain undiscovered and unrectified, and nowhere else have the patients so continuous a guarantee that the treatment they receive will be of the best, while the provision made for their comfort and welfare, owing to the unceasing and ever varying quality of the criticism to which the work of everybody, from the senior physician to the humblest official, is subjected in a clinical hospital, is unequalled anywhere else. At a great voluntary hospital, not only do hundreds of medical students and nurses work in the wards, but thousands of people, in the persons of the patients' friends, and those members of the public who take an interest in hospitals, pass through the wards in the course of every year. Again, each voluntary hospital has to live by competition, a fact which guarantees that everything in the way of new treatment and scientific development shall in due course find its proper place within the walls of such an establishment. Open as they are to the full inspection of everybody whose knowledge and presence can promote efficiency, the voluntary hospitals have shown, especially since the last quarter of the 19th century, a continuous development and improvement. Here the patients are treated with invariable kindness and consideration, as human beings rather than cases, to the great benefit of the whole human family as represented by the officials, the patients and the students, with their relations and friends, the honorary medical officers, hundreds of medical practitioners and nurses, who receive their medical training in the hospitals, and the ever-increasing number of governors and supporters by whose contributions voluntary hospitals live. The great missionary and social value of the voluntary hospitals to the whole community cannot be questioned, and they have been of inestimable value to the churches by inculcating the higher principles of humanity, while removing the many acerbities which might otherwise prevail between rich and poor in large cities.

The voluntary hospitals are attended, however, by certain disadvantages which do not attach to municipal institutions. A municipality which undertakes the provision of hospitals for the entire community is largely able to plan out the urban area, and to provide that each hospital site selected shall not only be suitable for the purpose, but that it shall be so chosen as to contribute to make the whole system of hospital provision easily accessible to all classes who may require its aid. The voluntary hospitals, on the contrary, have grown up without any comprehensive plan of the districts or any real regard to the convenience or necessities of their poorer inhabitants. Voluntary hospital sites were almost invariably selected to suit the convenience of the honorary medical staff and the general convenience of the hospital economy rather than to save the patients and their friends long journeys in search of medical aid. The best of the municipal systems too enables economy to be enforced in the administration by a plan which provides a central office in every town where the number of vacant beds in each hospital is known, so that the average of occupied beds in all the hospitals can be well maintained from an economical point of view. This speedy and ready inter-communication between all hospitals in a great city, which might perfectly well be secured under the voluntary system if the managers could only be brought into active co-operation, prevents delay in the admission of urgent cases, promotes the absence of waste by keeping the average of beds occupied in each establishment high and uniform, and has often proved a real gain to the poor by the diminution in cost to the patients and their friends, who under the best municipal systems can find a hospital within reasonable distance of their home in a large city wherever it may be placed. Another advantage of the municipal system should be that central control makes for economical administration. Unfortunately a close study of this question tends to prove that municipal hospitals for the most part have resulted in a dead monotony of relative inefficiency, often entailing great extravagance in buildings, and accompanied by much waste in many directions. Existing municipal hospital systems are attended by several grave disadvantages. The administration shows a tendency to lag and grow sleepy and inert. The absence of competition, and the freedom from continuous publicity and criticism such as the voluntary hospitals enjoy, make for inefficiency and indifferent work. Rate-supported hospitals, as a rule, are administered by permanent officials who reside in houses usually situated on the hospital sites, and who are paid salaries which attract the younger men, who, once appointed, tend to continue in office for a long period of years. This fixture of tenure is apt to cause a decline in the general interest in the work of the municipal hospital, due mainly to the absence of a continuous criticism from outside, and so the average of efficiency, both in regard to treatment and other important matters, may become lower and lower. Those who have habitually inspected great rate-supported hospitals must have met instances over and over again where a gentleman who has held office for twenty or thirty years has frankly stated that his income is fixed, that his habits have become crystallized, that he finds the work terribly monotonous, and yet, as he hopes ultimately to retire upon a pension, he has felt there was no course open to him but to continue in office, even though he may feel conscientiously that a change would be good for the patients, for the hospital and for himself. Under the voluntary system evils of this kind are seldom or never met with, nor have these latter establishments, within living memory, ever been so conducted as to exhibit the grave scandals which have marred the administration of rate-supported hospitals not only in Great Britain but in other parts of the world. We believe that the more thoroughly the advantages and disadvantages of rate-supported and voluntary hospitals for the care of the sick are weighed and considered, and the more accurate and full the knowledge which is added to the judgment upon which a decision can be based, the more certain will it be that every capable administrator will come to the conclusion that on the whole it is good for the sick and for the whole community that these establishments should, at any rate in Great Britain, be maintained upon the voluntary system. Of course it is essential to have rate-supported hospitals where cases of infectious disease and the poorest of the people who are dependent largely upon the poor-law for their maintenance can be cared for. It is satisfactory to be able to state that of late years the administration of both these types of rate-supported hospitals has greatly improved. The added importance now given all over the country to medical officers of health, and the disposition exhibited, both by parliament and government departments, to make the position of these officers more important and valuable than ever before, have tended largely to improve the administrative efficiency of hospitals for infectious diseases. No doubt the whole community would benefit if residents in every part of the country could be moved to take a personal interest in the infectious hospital in their immediate neighbourhood. Amongst the smaller of these establishments there has been so marked an inefficiency at times as to cause much avoidable suffering. The existence of such inefficiency casts a grave reflection upon the local authorities and others who are responsible for the evils which undoubtedly exist in various places at the present time. Unfortunately knowledge has not yet sufficiently spread to enable the public to overcome its fear and dread of infectious maladies. It is therefore very difficult to induce people to take an active interest in one of these hospitals, but we look forward to the time when, owing to the activity of the medical officers of health who have immediate charge of buildings of this kind, this difficulty may be overcome, when the avoidable dangers and risks and the appalling discomfort which a poor sufferer from a severe infectious disease in a rural district may suddenly have to encounter under existing circumstances, would be rendered impossible.

The poor-law infirmary in large cities, so far as the buildings and equipment are concerned, very often leaves little to desire. Poor-law infirmaries lack, however, the stimulus and the checks and advantages which impartial criticism continuously applied brings to a great voluntary hospital. Such disadvantages might be entirely removed if parliament would decide to throw open every poor-law infirmary for clinical purposes, and to have connected with each such establishment a responsible visiting medical staff, consisting of the best qualified men to be found in the community which each hospital serves. The old prejudice against hospital treatment has disappeared, for the least intelligent members of the population now understand that, when a citizen is sick, there is no place so good as the wards of a well-administered hospital. Looking at the question of hospital provision in Great Britain, and indeed in all countries at the present time, it may be said, that there is everywhere evidence of improvement and development upon the right lines, so that never before in the history of the world has the lot of the sick man or woman been so relatively fortunate and safe as it is in the present day. Probably it is not too much to say that to-day hospitals occupy the most important position in the social economy of nations.

_Classification of Hospitals._--Having dealt with hospitals as a whole it may be well very briefly to classify them in groups, and explain as tersely as possible what they represent and how far it may be desirable to eliminate by consolidation or to increase by disintegration the number of special hospitals.

_General Hospitals._--These establishments consist of two kinds, (a) clinical and (b) non-clinical, each of which, under the modern system, should include every department of medicine and surgery, and every appliance and means for the alleviation of suffering, the healing of wounds, the reduction of fractures, the removal of mal-formations and foreign growths, the surgical restoration of damaged and diseased organs and bones, and everything of every kind which experience and knowledge prove to be necessary to the rapid cure of disease. The clinical hospital means an institution to which a medical school is attached, where technical instruction is given by able and qualified teachers to medical students and others. A non-clinical hospital is one which is not attached to a medical school, and where no medical instruction is organized.