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regard to this difficulty, I ventured to suggest to the Asylums Board
the desirability of placing one or more of their experts at the service
of medical men to aid them in the diagnosis of doubtful cases, but
the Managers did not accede to the suggestion. The County Council,
subsequently, appointed certain practitioners to render this aid, but
the gentlemen so appointed could not, in some instances at least,
claim to possess the expert knowledge necessary to the discharge of
so delicate and difficult a duty. No case of small-pox in London was
removed direct from home to hospital. Every case was removed, in
the first instance, to the South Wharf Shelters at Rotherhithe, and
thence —if found to be suffering from small-pox —to Long Reach. If
the case was doubtful it was detained for observation. If it was
clearly not small-pox the patient was vaccinated or re-vaccinated and
sent home—information in such cases being forwarded to the Medical
Officer of Health. A few such cases occurred in the Borough and
happily not one of them was the worse for the journey. Medical
practitioners were encouraged by the Asylums Board experts to send
doubtful cases to the shelters, for diagnosis, which was the best
practicable course, the Board having, as above stated, felt unable to
supply the service of an expert at the patient's home. [On this
subject of diagnosis of doubtful cases, vide Reports Nos. 9 and 14,
1901, pages 124 and 196, and No. 2 Report, 1902, page 26.]
Conclusion.—I thought it desirable at the commencement of the
epidemic, which, as we have seen, was mainly confined to North
Kensington, to charge the Chief Sanitary Inspector with the sole
responsibility of carrying out the arrangements designed to prevent
the spread of disease, and it is simple justice to acknowledge that he
fulfilled this duty, which included the visitation of some hundreds of
"contacts" —by day and night, on week-days and Sundays alike, to
my entire satisfaction, and, I may add, with signal success.