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Thirdly.—The increased provision of hospital accommodation and
equipment for the removal and treatment of small-pox.
Fourthly.—With the notification of infectious disease local
authorities were obliged to put their sanitary staff upon a more
suitable scale for dealing with infectious disease, in the way of supervising
the isolation of cases which may ba suitably isolated at home,
the disinfection of homes, furniture, and articles of clothing, and the
adoption of other measures likely to prevent the spread of infectious
di ease.
These have no doubt contributed largely in keeping London almost
free from small-pox for about 18 years; but the outbreak of last year
shows that measures such as those indicated above are inadequate
alone to keep London free. I think it may be truthfully stated that
no place was ever so well equipped for dealing with an outbreak of
small-pox as London was last year; nor do I think that preventive
measure were ever better applied both by the Asylum's Board and
the Health Departments of the local authorities; but the result shows,
that the. one thing needed to rid London of this dread disease, is the
successful vaccination or re-vaccination of every person in London,
and that cannot be brought about except by the alteration of the law.
Besides a bracing up of the law relating to infant vaccination, a law
of compulsory re-vaccination is needed. Until this is brought about we
may expect a recrudescence of the disease at intervals of a few years.
There is one other circumstance connected with this epidemic
which should be mentioned. Early in the epidemic one or two
hemorrhagic cases of small-pox occurred, which terminated fatally
before they could be removed to hospital. The bodies were immediately
removed by the undertaker, who had the contract, to the
Mortuary, but, unfortunately one of the men employed by the undertaker
contracted the disease and died. The undertaker then declined
to remove any more bodies of persons dying from this disease; and I
could not obtain any other undertaker to contract for this work.
Subsequently cases were removed in one of the Borough disinfecting
vans to the Mortuary by the men employed in disinfection. This