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disease does not present the same opportunities of
spread of such disease, and that the mere numbers of
cases from the whole district is but an imperfect indication
of the existing risks of an outbreak on a large
scale. In the provinces, where the isolation hospital is
uuder the control of the sanitary authority, it is, or ought
to be, much easier to prepare for an approaching epidemic—the
hospital authority, i.e., the Health Committee,
having the Medical Officer to advise them of
such prospects. In London the notifications are sent
to the hospital authority, the Asylums Board, but
that authority has not the advantage of the knowledge
and advice of the medical officers of health. It
appears to be desirable that the hospital authority for
the Metropolis should be constituted from the
sanitary authorities, and that the medical officers of
health should be brought into closer touch with the
hospital board.
At the Conference held by the Marylebone
Vestry, a statement was made that the hospitals were
used by many persons who should be treated at home.
It is by no means easy to say who should, and who
should not use the hospitals, seeing that they are
maintained out of the rates. There are so many
factors which must be taken into consideration in
deciding the question of isolation of any given case,
of which factors the simple one of ability to properly
treat the patient at home is by no means the most
important. Taking the number of rooms occupied