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32
These percentages are not satisfactory, but are explainable
by the fact that there was great difficulty experienced
in getting infectious cases (more especially scarlet fever),
removed to the Hospitals of the Asylums Board— a state of
affairs that was accentuated towards the end of the year
1895, with the result that an official representation was
made by your Medical Officer of Health to the Board, asking
that special attention might be paid to the cases sent on by
your officials for removal. This representation, apparently,
had the desired effect, for I am able to report that I
experienced no further difficulty in getting cases removed
afterwards.
There is little doubt, I think, but that the deadlock arose
from the want of sufficient accommodation, and the apparent
absence of method in choosing the cases, and not from any
remissness on the part of the Managers, who did their best
under what were exceptionally trying circumstances.
During times of pressure, and with an insufficiency of
isolation accommodation, I submit that only the most
severe cases, the most destitute, and those that cannot
possibly be isolated at their own homes should be removed,
and that the choosing of such cases should be left to the
Medical Officer of Health for the particular District in
question. If no such system as this be adopted, isolation
in London must be more or less of a failure.
84.3% smallpox cases, 34.4% scarlet fever, 30.8%
typhoid, and 27.6% diphtheria, were removed to Hospital
respectively.
Table J gives the averages of Notification certificates
received in Lambeth since 1889, and it will be noted that
during 1895 the total number is 49 above the average— the
greatest number of Notifications being received in 1893—
though the incidence per 1,000 of the population during
1895 is below the average incidence for the years 1890—94
(i.e., since the introduction of the Compulsory Notification
Act).