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Mr. Burdett's labours in the cause of pay hospitals are too well known to need mention at our hands. To him is due the origin and subsequent development of the Home Hospitals Association, and he is generally recognised as the authority on the particular subject to which the present book relates. Mr. Burdett is extremely earnest in his advocacy of the system of payment-at any rate in part-for the benefits received in hospital, and he vigorously denounces the evils to which the present indiscriminate system of medical relief gives rise. He examines carefully, and with much painstaking detail, the working of the various systems of pay hospitals in vogue in France, Switzerland, Germany, Austria, Spain, Italy, Sweden and Norway, America, Canada, and the Colonies; and he expresses the opinion, in which we cordially concur, that middle-class or pay hospitals, if established in England on a proper basis, would probably become very popular and financially successful. In support of this view, he gives the opinions of gentlemen, who have given special attention to this particular question, and he also goes at great length into the reasons which make such hospitals desirable. No one, indeed, can rise from a perusal of Mr. Burdett's statements without feeling that the establishment of pay hospitals and pay wards would meet a real want in this country. Hospitals and hospital treatment are undoubtedly becoming more and more popular with the general public, and this result is hardly surprising. But it is none the less a grievous scandal that those who can afford to pay should be allowed fo go to these establishments to the exclusion of their poorer neighbors without in any way contributing to the funds of the hospital. Mr. Burdett proposes that whilst poor persons who can afford to contribute something towards their maintenance should be treated in the wards of the present general hospitals, the remunerative paying patients should be treated in separate hospitals of their own. In this way he would get over a difficulty which has been felt by many to be a great stumbling-block in the way of the extension of this desirable reform; and the arguments adduced in favor of this plan are certainly very cogent. Mr. Burdett gives an interesting account of a now forgotten institution, the first Pay Hospital established in England, by Dr. South wood Smith in 1840, together with a critical and exhaustive discussion of the efforts recently made by the treasurer of St. Thomas's Hospital to engraft the system of pay patients upon that institution. A lengthy chapter is devoted to the Home Hospital Movement, in which Mr. Burdett is more particularly interested. The importance of the objects which this useful society aims at fulfilling is very well brought out. We are gratified to find Mr. Burdett insisting strongly on the provision of hospitals for infectious diseases for the well-to-do, and of convalescent hotels, the need of both of which is now very grievously felt. The Home Hospitals Association, and the cause of pay hospitals generally, has a very earnest and powerful advocate in Mr. Burdett, whose book should be in the hands of every hospital manager in the country who desires to rescue the institution in which he is interested from the chronic impecuniosity to which but too many hospitals seem to be subject. -The Sanitary Record [1880]

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