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nursing and nourishment. That publicity—by which I mean only
information to the Sanitary authority—would be for the general good,
no well-informed person can doubt, and in a matter so vital to all it is
not unreasonable to expect that personal feeling and private interests
should yield to the paramount consideration of the public welfare.
The most satisfactory feature in connection with this deplorable
outbreak was the conspicuous usefulness of the special Hospitals
erected by the Metropolitan Sick Asylum Board under the provisions
of the Metropolitan Poor Act, 1867. The proportions of the epidemic
were vast and far reaching, but what limits it would have
attained, in the absence of hospital accommodation, it is impossible
to say. But we may realize something of the greatness of the
emergency in the fact that the Hospitals of the Board, irrespective
of District Hospitals, received 12,840 cases in the year, of which
2,351 died,—every one of which, if it had been treated at home
would have been a centre for the spread of disease. In local hospitals,
including the Old Hospital at Islington, there were 505 deaths,
making the grand total of deaths, in Hospitals, 2,856 out of the
7,876 which took place in the Metropolis.
From personal experience, I am able to say, that in a great number
of instances the speedy removal of a first case, followed by
disinfection of the room, bedding, clothes, &c, was attended with
the happiest results—the plague ceased. In 256 houses out of 321
where the disease existed, there was but a single case in each.
Wherever, in fact, this object was attained the disease rarely spread.
On the other hand, when numerous cases occurred in the same
house or family, the spread of the disease was generally traceable
to the unwillingness of the sick, or of the parents whose children
were ill, to avail themselves of the benefits of the Hospital, an
unwillingness which, unhappily, was fostered by prejudice arising
out of certain ex parte statements made to the disadvantage
of the management of the chief Hospital—charges which fortunately
for the inhabitants of this Metropolis, were shown to bo
without foundation after an exhaustive enquiry, conducted by !he
Inspectors of the Local Government Board.
Strongly impressed with a sense of the usefulness of the Hospitals
and the great benefit of early removal, both to the sick and to the
other inmates of infected houses, no pains were spared to discover
the sick and effect removal in suitable cases, i.e., cases in which
either the want of proper accommodation, or inability to provide
suitable nourishment, medical treatment and nursing was apparent.
I have to thank the Board of Guardians of the Poor, and their
Officers, for the readiness with which they complied with my request
for instant information of new cases. The Hospitals being ratesupported
admission to them can only be obtained through the
Relieving Officers, who, therefore, are usually the earliest to get
knowledge of fresh attacks.