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was 2,600, or about 700 in excess of the normal accommodation.
The great increase in the number of persons admitted
was largely due to the increased facilities afforded by the
Managers—whose new Regulations, issued in that year, permitted
of the reception of patients upon the application of any
duly qualified medical practitioner—and to an Order of the
Local Government Board giving effect to a recommendation
I had made in 1875, viz., that the certificate of any duly qualified
medical practitioner should be accepted as evidence of the nature
of the infectious disease. But the operation of compulsory
notification must not be left out of account in any explanation
of the growing disposition on the part of the public to make
use of the rate-supported hospitals; or, 1 would add, in estimating
the probable requirements of the future. How greatly
these causes, and the depauperisation, in 1883, of medical
relief in the hospitals, which I had been advocating since 1877,
operated to popularise the use of these institutions, may be
inferred from the fact that the admissions of scarlet fever cases
in 1891, when the mortality (589 deaths) was the lowest on
record, were no fewer than 5,262, or only about 650 less than
in the epidemic year 1887. These numbers were far exceeded
in 1892, the admissions having been 13,093, or 7,193 more than
in 1887, although the deaths from scarlet fever (1,174) were
269 fewer than in 1887, and 60 below the corrected decennial
average. The admissions in 1893, as we have seen, were
15,408.
If the demands for scarlet fever only upon the accommodation
provided by the Managers were so great, under the
circumstances above set out, it may well be asked, What would
the requirements be, should the Metropolis be again afflicted
with an epidemic like that of 1870, when the deaths from
this cause were 6,040 out of a population of 3½ millions?
or even like that of 1880, when the deaths were 3,100, out of a
population of 3¾ millions ? In the former year there were
no hospitals : the epidemic ran its course without check, and