IT is a matter of great satisfaction to announce, at the beginning of a new year, the completion of arrangements which will, as we hope and believe, bring our British, American, and Cauadian readers into closer communion. We are sure that much practical knowledge may be exchanaed with our Transatlantic brethren; and as we know that they have always received favourably our contributions to science, so should we be ghlcl to learn much from them in the way of good practical administration. For it

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... s to be remembered that the Americans have always been a highly practical people, and a visit to the various institutions in and around New York, as well as those of other States and cities in that vast continent, proves that we may glean many useful hints from the eminently systematic mode in which the working of large establishments is conducted. It is not, perhaps, known to many of our British readers that the public charities and correctional establishments of the city of New York are unitedly administered by a body of Commissioners. These establishments include prisons, hospitals, idiot, lunatic, blind, and orphan asylums, workhouses, almshouses, nurseries, penitentiaries, cemeteries, and a labour bureau. The general hospitals (two of which have been lately described in THE LANCET), are situated within the city; but those for the reception of fever, epileptic, small-pox, incurable, lunatic, and other special cases, are located on several islands east of, but tolerably close to; the capital. The Commissioners devote their whole time to official duty, and visit the buildings daily. Each of the hospitals is provided with paid resident officers, and all the general establishments are supervised by resident superintendents. It is also a specially noteworthy feature that a very important officer exists in the person of f, medical inspector, whose duty it is to visit the establishments at least once a week, to point out to the resident medical officers any dereliction of duty, waste of material, or other irregularity, and, if such be not remedied, to report to the Commissioners. We took occasion to visit all these institutions in the summer of last year, and are persuaded that their working arrangements will, with one or two exceptions, contrast favourably with our own establishments. The nurseries are excellently arranged, though the mortality of infants is reported to be very great, due probably, in many instances, to hereditary causes alone. The small-pox hospital is situated at the southern extremity of Blackwell's Island, and can be ventilated by all four winds. It was a matter of regret to notice that, in a new hospital just finished, and built on the pavilion system, the closets were placed in the centre of a large double ward, so that it is almost impossible to avoid ventilation into the latter. This by the way. We have directed attention to these institutions for the purpose of showing that, according to our own knowledge and belief, centralisation is the great key to administrative success. These establishments are conducted practically by a small body of energetic men, who direct the working of their superintendents and resident medical officers, and obtain from the medical inspector, who acts very judiciously as middleman, such information as can only be gleaned from an active professional man. A general rate is levied to defray the total cost of these establishments, and it is reported that the expenses are vary large indeed. But there can be no doubt that efficiency is best promoted by an administrative staff of paid officials, responsible to paid chiefs; and though we are not fortunate enough to possess, as do the New Yorkers, a series of little islands close to our own city, on which to locate the uick, suffering, dangerous, desperate, and destitute classes of the community, many lessons may be learnt, and much may be done, if the authorities at Gwydyr House, and those entrusted with the conduct of our own public hospitals, choose to take a leaf out of the book of the Commissioners or Public Charities and Correction of New York city.