templated from the first, and which will shortly be accomplished, which can be enlarged to any extent on the isolated pavilion plan, it is hoped and expected that the institution will soon devote much of its energies to cancer in all its forms and phases. The comparatively small number of persons with skin-diseases requiring treatment in bed may soon be greatly outnumbered by the cancer cases, but the institution will still remain a skin and cancer hospital, if the foregoing principles are correct, and if it is sought to do the greatest amount of good to the largest number of sufferers.
It being determined for these cogent reasons to adopt the plan of combining skin-diseases and cancerous affections in the same hospital, the problem arose as to the best method of carrying out the project, and for this purpose it was decided to establish a branch of the institution in the country adjacent to the city of New York. In his late address at the first annual meeting of the officers and friends of the hospital, Dr. L. Duncan Bulkley, the first of the medical officers, briefly reviews what has been done, and gives a very clear statement of the reasons that have induced the authorities to organize a country branch of the establishment. We give the main portions of his address:
"At this our first annual meeting, we find that the accommodations thus far secured are totally inadequate for the needs of the service; during the last few months our building has been quite as full as is desirable for health, while cases have been turned away which were unsuitable for our contracted quarters, and many male patients have been unable to gain admittance, all the beds devoted to this class being kept continually full....
"The object of our thought this evening is, therefore, the means of extending the capacity and efficiency of our hospital, that it may approach somewhat to the size and requirements demanded by the large numbers of sufferers who call for our sympathy and aid. How can these ends be best attained? In which direction shall we enlarge, and how can we secure the greatest benefits to those who put their lives and their health in our hands?
"The tendency has been in all cities to build large and expensive structures, into which the greatest number possible of patients should be crowded, with the impression that thereby the best medical and surgical aid was afforded to the largest number of individuals.
"But the matter of bringing many patients together for treatment in one room and under a single roof has been studied from statistics by a number of competent and conscientious persons, and the results obtained are not a little startling when the mortality of such institutions is compared with that found among patients in private houses, and in cottage hospitals made to conform as nearly as possible to the conditions found in private houses.
"While the present magnificent building of the New York Hospital was being erected in Fifteenth Street, a committee of the governors of
