which, for style of building, order, cleanliness, and internal arrangement, are superior, with but one exception, (and that exception is, the Hôpital des Pauvres, in the same city,) to any thing I have seen in other parts of Europe, even to those magnificent establishments, the Naval Hospitals of Haslar and Plymouth; and of course greatly superior to their own general Military Hospital, just described. I feel confident that did but one such institution exist in London, it would become the subject of general conversation among the profession, and would be visited as a matter of curiosity. If there must be a drawback to this general picture, it is, that the end in view in forming these hospitals, did not seem to require such a combination of every thing that money can purchase, or such magnificent arrangements. I cannot trust myself on the discussion of this subject in this place, and much less enter into a description of these different hospitals. I shall defer that to a future opportunity; but I cannot forbear saying, that, if the manner of treating diseases in these establishments, is on a par with every thing that the Imperial Government has done for the luxurious accommodation of its guards, there is no nobleman or wealthy individual in England, or elsewhere, who could desire, or, desiring, obtain a handsomer habitation in case of sickness, a more wholesome and better prepared diet, a greater number of personal comforts, a superior degree of cleanliness in the house, servants, bedding, or personal linen; and finally, a more assiduous and constant attendance than are enjoyed in these palaces for the sick, by private soldiers and subaltern officers. Fortunate it is, that the Russian soldier hates an hospital, and will often wish to be considered well, when, in reality, he is far from it, in order to be soon released from these chambers of sickness; or it would be difficult to get him to quit this institution when once ad

mitted into it. His Majesty, and the Grand-duke Michael, will frequently pay a visit to these establishments, either unattended, or with the smallest retinue imaginable, at uncertain periods, and without the least previous notice. It may be supposed that under such circumstances, the military hospitals must need be in the best order imaginable. The able hand of Sir James Wylie, the inspector-general of the military hospitals, is again visible in the very excellent condition in which those of St. Petersburgh are to be found at this moment. But, above all, it is the immediate and personal inspection of them by the Sovereign, who inquires into every branch of their service and manner of conducting them, promenades the wards, interrogates the patients, and encourages the attendants, which produces the striking effect here mentioned. The hospitals of the Preobrajensky and Semenoffsky regiments; of the Chevalier Guardes, and Guardes à Cheval (without alluding to the medical practice), are fit models for every civilized nation in Europe to imitate. The building of the Semenoffsky Hospital, which was erected by the late Emperor Alexander, when yet Grand-duke, is of the finest description. One particular circumstance struck me in the management of these hospitals; namely, the total absence of female nurses in all of them.

Independently of the Regimental Hospitals here alluded to, there is a general military hospital, situated in the fifth section of the Liteinoi district, and called the Artillery Hospital, which, though placed on a respectable footing, and somewhat better, in many respects, than that of Pedestrié, cannot be included in the general eulogium I have thought myself called upon by impartiality to pass on the former. The Artillery Hospital, which is as large as a village, consists of a great number of houses, built of wood, arranged in rows and squares, which contain the wards

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and receive patients from every regiment, or military depôt, that has no hospital of its own in the capital. also admits such patients as cannot be transferred to their own regimental hospitals, or otherwise disposed of in the Pedestrié, in consequence of interrupted communication, by the removal of the bridges on the Neva. I examined this establishment in all its details, and was present, by special invitation, at the removal of the arm of a guardsman at the shoulder joint, in consequence of the bone, which had been left after a former amputation, having protruded through the soft part to some extent, thus placing the patient's life in jeopardy, from the great discharge and irritation perpetually kept up. The operation was performed by a young military surgeon in a very creditable manner. It is principally for the use of this class of medical officers, that Sir James Wylie has established a Medico-Chirurgical Journal, published in Russian, at irregular periods, under his superintendence; the only work of the kind, I believe, to be met with in that Empire.

It is not my intention to say a word on the general subject of Russian medical and surgical skill, for reasons often repeated by me in the course of this work; but I must not omit, in this part of my book, to pay a wellmerited eulogium to Dr. Arendt, who is an honour to Russian surgery. He is, perhaps, the most skilful practitioner in cases of aneurism in existence, having performed the operation fourteen times, (in four of which he tied the external iliac artery,) and has been completely successful in twelve of them. His success too in his operations on the subclavian artery and external carotid, has been too long known to the medical world to need any particular notice. The resection of the mentonian part of the lower jaw, in a young girl, which included four of the front teeth, mentioned

in another place, and performed by him last year, for the purpose of effectually removing a carcinomatous tumour, and the neat manner in which he has restored the form, both internally and externally, of the jaw, so that very little deformity is perceptible, reflect the highest credit on his judgment and adroitness. In operating for the stone he has been equally fortunate. Ten times has he performed lithotomy in the last eight years, with the loss of one patient only. This gentleman's experience in military surgery has been very extensive. He made most of the campaigns with the Russian armies, and distinguished himself greatly by his bold operations, performed in the presence of the leading French surgeons of Paris, in the hospitals of which city the wounded Russian soldiers had been lodged. Arendt has since left the public service, and is engaged in considerable private practice. Having had many opportunities of conversing with him on professional subjects, and of meeting him in consultation, I may say that I found him to entertain what, in my humble opinion, appeared to me to be sounder views in pathology and the treatment of diseases, than I had generally noticed among some of his colleagues in the civil hospitals, of which he is, at this moment, Inspector-general. His modesty equals, in every respect, his professional superiority.

Dr.

It was in his company that I proceeded, on some other occasion, to visit the Civil Hospitals. There are four such establishments of importance in St. Petersburgh.

That of Obouchoff is the largest civil hospital, and contains 625 beds in all, including about 120 for lunatic patients treated at the charge of the city. It is situated on the quay of the Fontanka. It has an open ground railed in before it, and a very extensive front, with a large garden behind. The system of internal arrangement differs in every respect from that of the Military hospitals, and is by

no means so good. Wards, a quarter of a mile in length on the ground and first stories, are not calculated to insure that quiet, comfort, and silence, which are so essential in the treatment of disease. This hospital was, at the time of my visit, under repair; and the patients were crowded in some temporary wooden buildings, at the extremity of the garden. It is the modernized edifice intended for them that I object to, on account of the excessive length of the wards, which are 560 feet long, and 40 feet wide. It is but justice to add, that such wards are extremely well ventilated, that the beds are placed at a considerable distance from each other, and that both the bedding and bedsteads are of the best description for such an establishment. There is accommodation for 256 male, and 150 female patients. Their admission takes place on stated days, and is regulated by the opinion of the head-physician, and the number of the va cant beds in the hospital. Cases of danger are admitted at all times and in preference. There is a resident physician in the house, and two visiting physicians, one of whom must remain in the hospital four-and-twenty hours, taking it by turns to attend. The resident and visiting physicians go round the wards at eight in the morning in summer, and seven in the winter. The visiting physician, whose turn it is not to be in the house, visits the hospital morning and evening. Dr. Arendt, the Inspector-general, goes round twice a week. Dr. Meyer, a German by birth, is one of the visiting physicians, and, I understand, has a respectable private practice; we, however, differed greatly in our notions of diagnosis and the treatment of diseases. Still it is but justice to say, that his very minute mode of investigating every, even the smallest symptom of the complaint, which was regularly noted in a regis ter of the case, written in Latin, and for each of which he had a remedy, rendered him not amenable to the ap plication of an anecdote related to me by an elderly French