When Andrey Yefimitch came to the town to take up his duties the "institution founded to the glory of God" was in a terrible condition. One could hardly breathe for the stench in the wards, in the passages, and in the courtyards of the hospital. The hospital servants, the nurses, and their children slept in the wards together with the patients. They complained that there was no living for beetles, bugs, and mice. The surgical wards were never free from erysipelas. There were only two scalpels and not one thermometer in the whole hospital; potatoes were kept in the baths. The superintendent, the housekeeper, and the medical assistant robbed the patients, and of the old doctor, Andrey Yefimitch's predecessor, people declared that he secretly sold the hospital alcohol, and that he kept a regular harem consisting of nurses and female patients. These disorderly proceedings were perfectly well known in the town, and were even exaggerated, but people took them calmly; some justified them on the ground that there were only peasants and working men in the hospital, who could not be dissatisfied, since they were much worse off at home than in the hospital--they couldn't be fed on woodcocks! Others said in excuse that the town alone, without help from the Zemstvo, was not equal to maintaining a good hospital; thank God for having one at all, even a poor one. And the newly formed Zemstvo did not open infirmaries either in the town or the neighbourhood, relying on the fact that the town already had its hospital. After looking over the hospital Andrey Yefimitch came to the conclusion that it was an immoral institution and extremely prejudicial to the health of the townspeople. In his opinion the most sensible thing that could be done was to let out the patients and close the hospital. But he reflected that his will alone was not enough to do this, and that it would be useless; if physical and moral impurity were driven out of one place, they would only move to another; one must wait for it to wither away of itself. Besides, if people open a hospital and put up with having it, it must be because they need it; superstition and all the nastiness and abominations of daily life were necessary, since in process of time they worked out to something sensible, just as manure turns into black earth. There was nothing on earth so good that it had not something nasty about its first origin. When Andrey Yefimitch undertook his duties he was apparently not greatly concerned about the irregularities at the hospital. He only asked the attendants and nurses not to sleep in the wards, and had two cupboards of instruments put up; the superintendent, the housekeeper, the medical assistant, and the erysipelas remained unchanged.