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14
arrangements of the Managers of the Metropolitan Asylums Board for
the provision of Hospital accommodation for cases of infectious illness.
At the end of May the accommodation for Scarlet Ferer patients in the
Board's Hospitals was exhausted and patients could only be removed as
vacancies occurred, through death or recovery, so that although the
removal only of the most urgent cases, was requested, a delay of many
days often occurred before this could be done; and in some instances
the removal was deferred so long, that ultimately the patient remained
at home until recovery. There were also many cases where removal
was advisable and was desired by the patient or his friends, but no
application was made for removal as other more urgent cases were
awaiting admission. Some idea of the number of these cases may be
gathered from the fact that during the first 21 weeks of the year when
the accommodation was ample and cases could be promptly removed, of
228 cases 200 or 87 per cent. were removed; while during the remaining
31 weeks, of 475 cases 243 or only 50 per cent. were removed; so
that accommodation was required for about 100 more cases in Fulham
alone. The reason of the Managers being unable to cope with the
present epidemic of Scarlet Fever was principally due to the opposition
raised to their acquisition of additional sites; but they have now
succeeded in obtaining vacant land at Lower Tooting, Lewisham and
Shooter's Hill, which will suffice for Hospitals containing in all about
1500 beds; and additional buildings are also in course of erection at
the Eastern, the South Western and the Western Hospitals, so that
when Hospitals are erected on the sites already purchased and land is
obtained for one or more Convalescent Hospitals for the Southern
Districts, the Managers hope that these will be sufficient accommodation
for the ordinary requirements of the Metropolis; but even this additional
accommodation would be insufficient to meet the needs of an
epidemic such as we have recently experienced, and as unless the
system of isolating cases of infectious disease is completely carried
out, the money spent in half doing it is simply thrown away, it is to be
hoped that the Managers will not relax their efforts to obtain sites for
additional Hospitals until provision is made, not merely for the average
prevalence of infectious diseases, but for the maximum amount that is
likely to occur.
When the Hospitals were full, the selection of patients for the beds
becoming vacant daily by deaths or discharges was made by the