When the clock struck, Andrey Yefimitch would sink back into his chair and close his eyes to think a little. And under the influence of the fine ideas of which he had been reading he would, unawares, recall his past and his present. The past was hateful--better not to think of it. And it was the same in the present as in the past. He knew that at the very time when his thoughts were floating together with the cooling earth round the sun, in the main building beside his abode people were suffering in sickness and physical impurity: someone perhaps could not sleep and was making war upon the insects, someone was being infected by erysipelas, or moaning over too tight a bandage; perhaps the patients were playing cards with the nurses and drinking vodka. According to the yearly return, twelve thousand people had been deceived; the whole hospital rested as it had done twenty years ago on thieving, filth, scandals, gossip, on gross quackery, and, as before, it was an immoral institution extremely injurious to the health of the inhabitants. He knew that Nikita knocked the patients about behind the barred windows of Ward No. 6, and that Moiseika went about the town every day begging alms. On the other hand, he knew very well that a magical change had taken place in medicine during the last twenty-five years. When he was studying at the university he had fancied that medicine would soon be overtaken by the fate of alchemy and metaphysics; but now when he was reading at night the science of medicine touched him and excited his wonder, and even enthusiasm. What unexpected brilliance, what a revolution! Thanks to the antiseptic system operations were performed such as the great Pirogov had considered impossible even _in spe_. Ordinary Zemstvo doctors were venturing to perform the resection of the kneecap; of abdominal operations only one per cent. was fatal; while stone was considered such a trifle that they did not even write about it. A radical cure for syphilis had been discovered. And the theory of heredity, hypnotism, the discoveries of Pasteur and of Koch, hygiene based on statistics, and the work of Zemstvo doctors!