That excellent paper, the _Builder_, mentions the lingering of the smell of paint for a month about a house as a proof of want of ventilation. Certainly--and, where there are ample windows to open, and these are never opened to get rid of the smell of paint, it is a proof of want of management in using the means of ventilation. Of course the smell will then remain for months. Why should it go? [12] [Sidenote: Why let your patient ever be surprised?] Why should you let your patient ever be surprised, except by thieves? I do not know. In England, people do not come down the chimney, or through the window, unless they are thieves. They come in by the door, and somebody must open the door to them. The "somebody" charged with opening the door is one of two, three, or at most four persons. Why cannot these, at most, four persons be put in charge as to what is to be done when there is a ring at the door bell? The sentry at a post is changed much oftener than any servant at a private house or institution can possibly be. But what should we think of such an excuse as this: that the enemy had entered such a post because A and not B had been on guard? Yet I have constantly heard such an excuse made in the private house or institution and accepted: viz., that such a person had been "let in" or _not_ "let in," and such a parcel had been wrongly delivered or lost because A and not B had opened the door! [13] There are many physical operations where _coeteris paribus_ the danger is in a direct ratio to the time the operation lasts; and _coeteris paribus_ the operator's success will be in direct ratio to his quickness. Now there are many mental operations where exactly the same rule holds good with the sick; _coeteris paribus_ their capability of bearing such operations depends directly on the quickness, _without hurry_, with which they can be got through. [14] [Sidenote: Petty management better understood in institutions than in private houses.] So true is this that I could mention two cases of women of very high position, both of whom died in the same way of the consequences of a surgical operation. And in both cases, I was told by the highest authority that the fatal result would not have happened in a London hospital. [Sidenote: What institutions are the exception?]