View report page

43
telephonic message is sent to the hospital to prepare for the
reception of a patient, and to despatch the ambulance; the
sanitary inspector at once proceeds to the house notified, and
urges the removal of the patient to hospital, and also the removal
of those who have been in contact with him to the
quarantine wards near the hospital. There is rarely any
difficulty in securing the removal of the patient; in the case of
the other inmates of the infected house, there is no power of
compulsory removal, but persuasion has generally been successful.
If a person liable to infection is not quarantined, he is visited
daily by the inspector ; he is warned against going to work, or
undue exposure, but is not confined to the house. Compensation
has been given in some cases. The history of the small-pox
patient is then inquired into, especially his whereabouts, and the
persons he has been in contact with during the preceding
fortnight, and any clue of infection is vigilantly followed up.
Meanwhile, the house is thoroughly disinfected, and clothing is
either burnt or sent to the steam disinfector on the hospital
grounds. There are 28 beds ordinarily set aside for small-pox in
a separate pavilion at the hospital; in another building, fenced
off from this, but very near it, cases of scarlet fever are received,
and the quarantine wards are separated from the fever wards by
a corridor only.
If no small-pox appears among those quarantined, they are
allowed to return after 14 days ; vaccination or re-vaccination is
offered them, but it has not been largely accepted. From 1877
to 1891, inclusive, it appears that 183 persons were thus quarantined,
and 103 patients were treated in the small-pox hospital.
of 14 persons quarantined in 1887 two developed small-pox, and
of 39 quarantined in 1888 three developed small-pox.
Proceeding the Commission state :—
We have no difficulty in answering the question, what means
other than vaccination can be used for diminishing the prevalence of
small-pox?—We think that a complete system of notification of the
disease, accompanied by an immediate hospital isolation of the
persons attacked, together with a careful supervision, or, if
possible, isolation for sixteen days of those who had been in
immediate contact with them, could not but be of very high
value in diminishing the prevalence of small-pox. It would be
necessary, however, to bear constantly in mind as two conditions of
success, first, that no considerable number of small-pox patients
should ever be kept together in a hospital situate in a populous
neighbourhood, and secondly, that the ambulance arrangement
should be organised with scrupulous care. If these conditions
were not fulfilled, the effect might be to neutralise or even do
more than counteract the benefits otherwise flowing from a
scheme of isolation.
After various points of evidence they say :—
We can see nothing then to warrant the conclusion that in this
country vaccination might safely be abandoned, and replaced by
a system of isolation. If such a change were made in our method
of dealing with small-pox, and that which had been substituted