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7
single case of small-pox in the Homerton Hospital. Indeed,
the result of my personal experience shows that it would be
safer for the district that cases should be treated at home, than
that the Homerton Hospital should be again occupied with
small-pox cases as before. The statistics of cases treated at
home, when due care as to disinfection and isolation were used,
indicate that they rarely acted as centres of infection from
which the disease spreads, whilst repeated outbreaks occurred
in the vicinity of the Hospital, apparently from new infection.
I object to a single case being treated in the Hospital, because if
that were done, more would almost certainly be brought there,
because of the great comparative expense of treating a small
number of cases in the ships.
Scarlet Fever.—My statistics as to scarlet fever, which I
now present to you, show that it is not at all likely to spread
from a hospital in the way that small-pox has done, and that
whilst it is almost certain that hospitals for small-pox in London
have proved injurious, those for scarlet fever tend to reduce the
spread of that disease. The number of scarlet fever cases in
each house invaded is greater than with small-pox, because
there is no protection against its spread except isolation and
efficient disinfection, whilst we can adopt vaccination and revaccination
for preventing the spread of small-pox.
During the year I have received notification of an unusual
number of cases of scarlet fever, but the ratio of attacks to deaths
has been much smaller than in former epidemics. For instance,
in 1882 there were 459 cases reported as having occurred in 287
houses situated in this district, whilst in 1886 there were 417
cases in 282 houses, with 144 deaths in 1882, and only 70 in
1886. The mildness of the epidemic is shown by the fact, that
although the cases were considerably more numerous than
usual, the deaths, 70, were below the average of the preceding
10 years, which amounted to 81. The comparatively small
mortality from the disease can scarcely have been connected