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On 10th October I reported on the subject as follows:
"With reference to the letter and memoranda received to-day from the Local Government
Board—the matter, moreover, being one of urgency—I think it right to direct the
attention of your Vestry to the advice tendered by the Board to Sanitary Authorities
generally on the subject of proceedings which are advisable with a view to the prevention
of epidemic disease, including plague.
"The Board observe that if the plague obtains foothold in any district, it will specially
affect insanitary areas such as are peopled by the poorest class, and where overcrowding
of persons in houses, and dirt and squalor of dwellings and of inhabitants, tend to
prevail; and they advise that—
' Wherever there is nuisance of any sort, it should, as promptly as possible, be abated,
and precaution should be taken not to let it recur.'
"The Board, while urging that Local Authorities should be on their guard against plague,
add that it is not intended to suggest that there at present exists any cause for alarm;
but they evidently consider that means of prevention should be adopted forthwith—
viz., by putting insanitary areas and poor districts into the best practicable sanitary
condition.
"All this is very much what I said in my ninth report (dated 13th September), which was
referred to the Sanitary Committee, as I had recommended the employment, temporarily,
of additional Sanitary Inspectors to make special inspections and assist in the enforcement
of the law with regard to the cleanliness of premises, overcrowding, &c."
The Committee not having submitted any recommendation for the appointment of
temporary inspectors, I again called attention to the desirability of such appointments
being made, in view of the advice given by the Local Government Board, and the action taken
by the Asylums Board in making hospital provision, etc., and by the County Council, who had
arranged to provide reception houses for "contacts," i.e., persons who have been in contact with
actual or suspected cases of plague. The Vestry decided forthwith to appoint four temporary
inspectors for a period of six weeks, the result being that a good deal of house-to-house inspection
was carried out in the poorer part of the borough, especially in North Kensington, efforts
being specially directed to cleansing of rooms, the removal of filth and rubbish from, and the
disinfection of unpaved yards—suitable breeding-grounds for the bacillus pestis.
The Public Health Committee of the London County Council gave much attention to the
subject, and their report on "Precautions against Plague in London" (26th September) was
adopted by the Council. This report set out the action recommended with respect to the provision
of "isolation homes" for persons who had been in contact with cases of plague, and
advised that the Council should provide all necessary accommodation" rather than that the
duty should be divided among a number of local sanitary authorities." The Council had been
asked by the Local Government Board, How long it would take to" get such accommodation
ready for immediate use—say for 1,000 persons in 200 families"? The Committee stated that
the Council had properties available, "some of which could at a few hours' notice be rendered
fit for occupation, while the repairs at the others would not take more than a few days;" they
were willing, moreover, to" provide or obtain any further accommodation that might be
necessary." "The actual cases of plague would be sent to the hospitals of the Metropolitan
Asylums Board," while " the medical inspection of infected areas, and disinfection of premises
and articles after cases of plague, would........be undertaken by the sanitary authorities."
The Council, moreover, made arrangements, with a view to cases or suspected cases of plague
being inquired into by a medical man familiar with the disease, and for bacteriological
examination in suspected cases. It may be mentioned that under section 13 of the London
County Council (General Powers) Act, 1893, the Local Government Board have power to
" assign to the Council any powers and duties under epidemic regulations made in pursuance of
the Public Health Act, 1875, which they may deem it desirable should be exercised and performed
by the Council." But the Board, while deeming it desirable that preparations should
be made, did not think it necessary to issue such regulations.
A few cases of plague subsequently occurred at different places, but the symptoms of the
disease as observed at Glasgow had been described so fully in the medical press that it was
speedily recognised, precautionary measures were adopted, and there was no spread. At all
ports vigilance was exercised. In London the Asylums Board set apart wards at the SouthEastern
Hospital (at Deptford) for the reception of possible sufferers, this hospital being the
nearest to the river. So far, happily, the country has escaped any serious outbreak, and the
machinery for dealing with such a possible contingency is kept in readiness for any emergency.