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Untoward results to other persons, from bringing small-pox to the site of the general hospital for
purposes of isolation and treatment have been seldom observed, and this, in Germany, is with one
consent attributed to the protection which is conferred on the population by statutory vaccination and
re-vaccination. Without these the German method, it is unanimously admitted, would break down.
"It has been asserted in England, by persons who have little or no faith in the value of
vaccination as a prophylactic against small-pox, that the comparative immunity of the German nation
from that disease is due, not to statutory vaccination and re-vaccination, but to the strict system of
isolation of Small-pox which is carried out in Germany. But the evidence given to me by the
eminent medical men, with whom I personally conferred, entirely refutes this assertion; and
one and all joined in the representation that compulsory vaccination and re-vaccination were Germany's
great protectors against small-pox.
" The description which I have given of the position of the small-pox pavilion at each of the
hospitals visited in Germany shows conclusively that there is not in that country the strict system of
isolation of small-pox in the sense as we in England understand it. With one or two exceptions the
pavilion is shut off in no way from the rest of the hospital, and there is no limitation in the number of
persons residing within the several zones around the hospital. Nor is the administration of the smallpox
pavilion entirely separate from the general administration of the hospital establishment. The
German nation, therefore, by the agency of compulsory vaccination and re-vaccination is able to
dispense with separate small-pox hospitals altogether. It is not necessary there to provide for smallpox
a separate site nor separate administration. Germany is in this way freed from great expense,
not to speak of the suffering and inconvenience which fall upon the English nation.* But all this
could not be achieved in Germany unless the law of Compulsory Vaccination and Re-Vaccination
were thoroughly carried out.
"Germany, indeed, would have less need even for small-pox pavilions on the sites of her
general hospitals than she has at present, were it not for the continual importation of small-pox by
foreigners, or by German subjects returning from foreign countries.
" Should Germany's Vaccination Law at any future time be carried out less efficiently than at
present, she may not only have to face the inconvenience of having to isolate more small-pox cases, but
may also be driven to provide separate accommodation for small-pox eases at a distance from populous
areas, and to endure the further expenses of separate administration and the like."
CHICKEN-POX.
The notification of chicken-pox which had been enforced during the greater part of the smallpox
outbreak was continued until January 6th, 1903 inclusive. It was not then again renewed as
the outbreak of small-pox in London was then practically at an end.
In this Borough notification of chicken-pox began on the 19th October, 1901, and during the
period to the 6th January, 1903 inclusive, 282 notifications were received, 114 belonging to St. Giles
and Bloomsbury, and 168 to the Holborn District. Of these totals only three referred to the year
1903, one belonging to St. Giles and Bloomsbury, and two to Holborn.
* " For the purpose of comparison I append a statement of the requirements of the Local Government Board as to
small-pox hospital sites provided by means of loans sanctioned by them. The following is an extract from the Memorandum
' On the provision of Isolation Hospital accommodation by Local Authorities, 1902':—
"' Hospitals for small-pox. In view of the frequently-demonstrated liability of small-pox hospitals to disseminate that
disease to neighbouring communities, and in order to lessen the risk of such occurrence, the Board require the following
conditions to be complied with in the case of small-pox hospitals provided by means of loans sanctioned by them.
" ' Ist. The site must not have within a quarter of a mile of it either a hospital, whether for infectious diseases or not,
or a workhouse, asylum, or any similar establishment, or a population of as many as 200 persons.
" ' 2nd. The site must not have within half a mile of it a population of as many as GOO persons, whether in one or
more institutions, or in dwelling houses.
" ' 3rd. Even where the above conditions are fulfilled a hospital must not be used at one and the same time for the
reception of cases of small-pox and of any other class of disease.'