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adopt such methods of transport which would do away with the necessity
of a resting-place on the high road.
The Managers are, as at present constituted, responsible for this
transport between London and the ships, and, of course, can make any
arrangements they please; but to embark on any acquisition of land and
material for the prevention of conditions which only arise occasionally in
cases of smallpox epidemics, which are themselves but infrequent seems
an expensive and useless proceeding.
The Metropolitan Asylums Board further lay stress on the desirability
that London should be cleared day by day of smallpox, and in this,
of course, all would concur ; but that it would be a danger to the public
health if the cases were aggregated at the shelters pending the changing
of the weather I do not believe. The idea as to the dangerous
nature of this proceeding is probably dependent on the theory that areas
around hospitals are specially liable to attack in spite of their complete
isolation, that is, that the disease would be aerially conveyed. This is, or
certainly was, the view of the Local Government Board, but it is not by
any means proved, and there are some exceedingly powerful arguments
against it.
Finally, the Managers complain of the action of Dr. Dudfield. He
may have, perhaps, misunderstood their proposal, but as a ratepayer I
think he has done a public service by calling attention to the matter ; and,
in recommending his Council to appeal in opposition to the scheme to the
Local Government Board, he will have forced the Managers of the
Metropolitan Asylums Board to prove and establish their position, and
not allow them to rush into a hastily formed and ill-digested scheme
which will lead to the waste of public money.
I am, Gentlemen, your obedient servant,
FRANCIS STEVENS, Medical Officer of Health.
The Council decided on September 24th to ask the
Local Government Board to hold such inquiry.
As a result of the interest aroused by the holding in
London in 1901 of the international Congress for the Prevention
of Tuberculosis, various means devised for the lessening of
this disease have been brought prominently before both the
sanitary authorities throughout the country and the public. In
several districts of London phthisis has been made voluntarily
notifiable, i.e., the Borough Councils have agreed to pay a certain
sum, usually half-a-crown, for each case of phthisis notified by
a medical practitioner, but they have not put into operation the
compulsory sections to this effect of the Public Health
(London) Act.
I have before declared my opinion as adverse to the
idea of benefit being obtained by notification of phthisis, and
so far I have seen no reason for altering that view, although
I feel that I am at present on the unpopular side.