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St. George-in-the-East.—The measures adopted in 1892 were again revived.
Mile-end Old-town.—The medical officer reported that arrangements made in 1892, together
with those which could be made at very short notice, would be sufficient.
Limehouse.—It was decided to erect a hospital, should occasion require, on the vacant land
belonging to the County Council in Cranford-street, Ratcliffe.
Poplar.—The medical officers of health reported in July on the result of their enquiries as to
sites for temporary hospitals, and as to the use of houses for shelters should there be necessity for such
provision, as to the division of the district into suitable areas for visitation by medical men, and as to
the arrangements that could be made for the treatment of cholera and diarrhoea. Improvement of
apparatus for disinfection is strongly recommended.
St. George-the-Martyr.—The medical officer of health referred to his report for the previous
year, and to the letter of the Metropolitan Asylums Board, indicating the stations which would be
available for ambulances. The lists of institutions in south London into which cases of cholera could
be received is also given.
Wandsworth District.—The medical officers of health reported on the arrangements which
would have become necessary in the event of prevalence of cholera. Thus hospital accommodation,
places of refuge, visitation of poorer houses, medical attendances, nurses, &c., disinfection of houses,
destruction of infected clothing, and interment of the dead, are referred to. Plans for a temporary
hospital in Wandsworth parish were prepared. In Streatham " a site was obtained, hospital tents
provided, and other arrangements made."
Greenwich.—Greenwich parish.—The medical officer of health made recommendations as to the
division of the district into suitable areas for the arrangements for the medical treatment of sick
persons, and reported as to the hospital accommodation available. Deptford parish.—The medical
officer of health reported that " every arrangement was made in case it [cholera] should appear
among us."
Woolwich.—The medical officer of health reports "proper steps were taken for dealing with
any outbreak of this disease if it had occurred, both in the direction of providing proper medical
and nursing treatment and in the provision of litters and hospital accommodation, this latter being
again found in the Woolwich infirmary."
Plumstead.—The medical officer of health reports—" I was in communication with the County
Council and the Asylums Board on the subject, and advised as to preparation for ambulance stations,
&c. I also made arrangements to secure the services of trained nurses in case they were needed,
and the committee authorised me, in the event of cholera appearing, to take any measures which I
might deem necessary before I could consult them."
During April, 1893, an international conference was held at Dresden with a view to agreement
as to the measures which could be adopted for the prevention of cholera in European countries. The
conclusions of the conference were made public at the end of June. It had been arranged that
notification of the existence of cholera in a country was to be given to all the governments represented
at the conference, but unfortunately it was decided that isolated cases should be ignored, and only a
cholera focus (" Foyer ") was to be notified.
This understanding rendered the undertaking practically valueless. The conference fixed a
maximum of restriction as to land traffic, sea traffic and merchandise, which the contracting governments
undertook not to exceed, while certain minimum restrictions were to be enforced by the countries
concerned. An important proposal was adopted to the effect that vessels were to be deemed infected
only if they had had cholera on board within seven days of arrival, and that they were not to be dealt
with as infected ships merely because they had sailed from an infected port. Certain recommendations
were made as to modifications, under particular conditions, of the restrictions placed upon the
importation of rags.* The conclusions of the conference constituted a distinct advance in the direction
of the removal of quarantine restrictions.

During these years, therefore, both cases and deaths have been increasing in number.
* The Local Government Board had in 1892 made orders to the effect that no rags from France, or from
any port in the Black Sea, or Sea of Azof, or from any other port of Turkey in Asia, and no rags, bedding, or
disused or filthy clothing from any foreign port in Europe north of Dunkirk other than ports of Sweden,
Norway, or Denmark, should be delivered overside except for the purpose of export or disinfection.
On the 7th August, 1893, by a further order, these orders were relaxed so far as they related to rags
packed in bales and imported as merchandise; and the above requirements were restricted in their application
to dirty bedding or disused or filthy clothing, the terms " bedding " and " clothing " being held to include such
articles when torn up, but not to include rags packed in bales or imported as merchandise. This order
further provided for the destruction by the sanitary authority or their medical officer of health, at the cost of
the person having control over the same, of any bedding or clothing delivered overside or landed for the purpose
of disinfection or destruction and not disinfected or destroyed by such person within 48 hours.
On the 13th September, 1893, a further order was issued defining the words " rags packed in bales and
imported as merchandise," in the order of 7th August, to mean rags compressed by hydraulic force, transported
as wholesale marchandise in bales surrounded by iron bands and with marks and numbers showing their origin,
and accepted as such by the Commissioners of Her Majesty's Customs.
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