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41
the medical men practising in Lambeth are to be congratulated.
There can be little doubt that the circular letter, which was sent
out early in the epidemic, helped materially in securing the prompt
notification of all cases.
2. Isolation.
Every case was at once removed to Hospital*—a most efficient,
and the only efficient, way of isolating Smallpox patients. Isolation
at home is practically impossible, and everything depends
on the cases being isolated in Hospital as soon as notified. This
has been accomplished in Lambeth, patients being removed, and
disinfection commenced, within an hour of such patients being
notified. In many instances, removal took place at night, and in
a few instances at midnight, arrangements having been made at
the Sanitary Offices for a person to be on duty at all hours (Sundays
and week-days). The routine adopted by the Metropolitan
Asylums Board (the Hospital Authority for London) is to take
each patient (when notified) first to the Shelters or Observation
Wards at Rotherhithe (South Wharf), since enlarged. From these
the patient, if found suffering from Smallpox, is sent in one of the
river ambulances to the Hospital Ships, which are moored at
Long Reach (the mouth of the Thames). Here the patient is
again medically examined, and if still thought to be suffering from
Smallpox (but not otherwise), is admitted on to the Ships.† In
this way, all danger of allowing a patient (not suffering from
Smallpox) to be placed in a Smallpox Hospital is practically reduced
to a minimum, and the method has been found to work
satisfactorily. 33 notified cases of Smallpox from Lambeth were
returned at once from the Shelters, such patients, in the opinion
of the Metropolitan Asylums Board's officials, not suffering from
Smallpox at the times of their removals from their homes. These
cases have been withdrawn and do not appear in the total number
of cases (404) dealt with in the Report. These 33 wronglydiagnosed
cases consisted of Chickenpox, Measles, Acne, Influenza,
Erythema, etc.
No possible harm can arise from the removal to the Shelters
for observation of doubtful or suspicious cases.
* Two patients (malignant Smallpox), died before the ambulance arrived
so that they could not be removed to Hospital. Their bodies were at once
removed to the Mortuary for infectious cases, at Wanless Road, to await
burial, at a cost of £114s. 6d. Strict precautions were taken as to disinfection,
etc.
fAt the beginning of the Outbreak, the Metropolitan Asylums Board had
available 1250 beds (ships 250 and Gore Farm, 1000). Extra accommodation
was needed, and provided, so that the present accommodation (1903)
in 3238 beds.