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73
THE METROPOLITAN ASYLUMS BOARD.
Under the provisions of the (now repealed) Sanitary Act, 1866, the local sanitary authority
was endowed with power to provide, for the use of the inhabitants of their district, hospitals for
the reception of the sick; a provision re-enacted in section 75 of the Public Health (London) Act,
1891. But, excepting in a few districts, and for limited periods in time of emergency; e.g., when
small-pox was epidemic, this power was not exercised, notwithstanding official pressure brought to
bear to induce sanitary authorities to erect local hospitals. The late Vestry originated opposition
to the establishment of such hospitals; and no one now doubts that the policy of that body was
wise, and fruitful of benefit to the entire Metropolis. In 1867 the Metropolitan Poor Act brought
the Asylums Board into existence, and this body set to work forthwith to provide infectious disease
hospitals, nominally for paupers only. As a matter of fact, however, and despite the disabilities
attaching, in theory, to the use of the hospitals, they were largely used from the beginning by
non-paupers; and in course of time legislation secured to the inhabitants of the Metropolis all of
the advantages for which, at my instance, the late Vestry contended—from 1877 onwards. The hospitals
are now free to all, no disability attaching to the use of them. The Managers have carried out
their work admirably, and having created for London an unequalled hospital service, fulfil the
duties originally devolved upon the local sanitary authorities; duties which those authorities
would undoubtedly have had to perform but for the creation of the Board, and the subsequent
legislation which has so enhanced their power as to leave little to be desired.
The Institutions administered by the Board are 51 in number, amongst them being 16 hospitals
for infectious disease—including the Southern Hospital, which has not been used hitherto
(Vide page 43).
There are three Homes for children, a land ambulance service (8 stations) and a river
ambulance service (3 wharves, 5 steamers). The Board's properties comprise an area of about
1,500 acres.
The work of the Board is set out in an annual report which had not been published when this
report went to press; I am debarred, therefore, from giving much of the customary information of
the operations of the Managers in respect to the hospital treatment of infectious disease, subjects
naturally of interest to Sanitary Authorities. But I have been favoured by the Clerk to the Board
with the following short summary of the operations of the year, and other particulars qu& infectious
disease.
Notifications.
Admissions
to hosnitals.
Death-rates,
1907.
(i.) Scarlet fever 25,925 22,764 2-80
(ii.) Diphtheria 8,598 5,744 9*58
(Hi.) Enteric fever 1,894 541 18*15
(iv.) Typhus fever 5 8—
(v.) Smallpox 8* 8 —
(»».) Cerebro-spinal meningitis 182 4 25.00
Number notified in year—all infectious diseases—41,023; of these 36,271 were legally admissible
to the Managers'hospitals, and 31,068 were admitted—85-7 per cent.: 37,100 patients were treated at
the fever hospitals; 1,405 persons died, 6,193 remaining at end of year.
Maximum number under treatment was recorded 19th November 7,158
Minimum number under treatment was recorded 11th May 3,563
Seaside Homes.—Amongst the most interesting of the Board's institutions, I rank the
Children's Homes—" Millfieid," at Rustington, near Littlehampton, and " East Cliff House,"
Margate. These Homes are for children "requiring either special treatment during convalescence,
or the benefit of seaside air—including children suffering from tubercular diseases
of bones, joints, or glands, and pulmonary phthisis." Millfieid Home, to which medical
cases of tuberculosis are sent, was improved in 1906 " by the provision of a sun room
. . . and new verandahs, 8 feet wide, projecting from dormitories on the first floor of
two of the blocks, with provision thereon of 18 beds for outdoor sleeping. This is said to
" materially contribute " to the facilities for the treatment of pulmonary tuberculosis. Children
" rapidly become accustomed to sleeping in the open, ana do not appear in any way to
suffer from this apparent exposure; the balconies only being closed for extreme stress of
weather." East Cliff Home " accommodates all cases of tubercular bones and glands, including
many requiring operative treatment." A verandah facing south, and fitted with 35 beds,
is in constant use all the year round. The results of treatment at these institutionsi is most
satisfactory; the pity of it is that the benefits of the Managers' care for sufferers from
tuberculosis should be limited to persons under the age of 16 years.
Gore Farm Hospitals, Upper and Lower, were utilized for convalescent scarlet fever
cases, as also was, during several months at the height of the epidemic, the Joyce Green
Small-pox Hospital.
* Six not suffering from small-pox.