Every Morning all the Wards ought to be scraped and swept, and afterwards sprinkled with warm Vinegar; and when dirty, they ought to be washed after the Fires are lighted.
Every Thing in the Wards, and about the Sick, should be kept as clean as possible; the Chamber-Pots and Close-Stools ought to be carried away as soon as used, and immediately emptied and washed before they be brought back.
The Windows of the Wards ought to be kept open to admit fresh Air Morning and Evening, for a longer or shorter Time, according as the Weather will permit.
If the Wards are close, and the Cieling too low, Dr. Pringle advises to remove some Part of them, and to open the Garret Story to the Tiles[157]; and if the Opening of the Windows is not sufficient to air the Wards, Ventilators of different Kinds, such as those mentioned by Dr. Hales and Dr. Pringle, may be used, especially when the Weather is hot.
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 always sufficient; but that he seldom or never knew a proper Application of Fire and Smoke to be unsuccessful in producing the happy Consequence of effectually purifying all tainted Places, Materials, and Substances[158].
In all Military Hospitals, at least in the fixed ones, one Ward ought to be always kept empty; and whenever a malignant Fever, or any other infectious Disorder, breaks out in any Ward, the Men ought to be removed into this empty one; and the foul Ward purified, by washing and cleaning it well with Soap and Water, and then with warm Vinegar; and afterwards purifying it with Smoke, in the same Manner as is practised in his Majesty’s Ships of War; and Fires should be lighted daily, and the Windows kept open for some Time, before any Sick be again admitted into it.