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"Joyce Green Estate. On this estate the Managers proposed to
provide beds for 940 patients, but the Local Government Board
have refused to sanction provision being made for more than 400
patients."
The net result is, that there will soon be 6,182 beds for fever
and diphtheria; viz., 4,527 for acute cases, and 1,655 for convalescent
cases; and 1,892 beds for small-pox, viz., 700 for acute cases,
and 1,192 for convalescent cases. The Royal Commission, in 1892,
recommended the provision of 3,000 beds for fever, and 2,700 beds
for small-pox. Times have changed since 1892, when my estimate of
the needs of the Metropolis, viz., "at least 5,000 beds for scarlet
ever, diphtheria and isolation "was deemed to be excessive.
As to small-pox accommodation, I am not disposed to quarrel
with the action of the Local Government Board in limiting the
immediate provision at the Joyce Green Estate to 400 beds, having
regard to the remarkable diminution in the prevalence of this disease
as a result of its extra-mural isolation first practised, upon my
recommendation, in May, 1881. In a sense it is now a matter of
ancient history, but the facts, forgotten doubtless, are worth
recalling in explanation of the comparative freedom from this
loathsome disease which London has long enjoyed.
The Asylums Board were first called upon to provide for the
accommodation of small-pox patients at the end of 1870. During
the ten years, 1871-80, they dealt with upwards of 33,000 cases, all
of which were treated in the Town Hospitals. The deaths in
London in the ten years were 15,539, including 7,912 in 1871.
In May, 1881, the "Camp Hospital" was opened at Darenth, and
the system of removing cases of small-pox to the country thus
initiated was gradually perfected, so that for many years all of the
sufferers coming under the Managers' care have been treated at
extra-mural hospitals. During the ten years, 1887-96, the number of
cases admitted to the hospitals was 5,232. The deaths in London
were429 only, and of these 206 were registered in 1893, in which
year 2,376 cases of small-pox were admitted to the Managers'
Hospitals. Had the mortality during the ten years, 1887-96, been at
the same rate as in the ten years, 1871-80, regard being had to
increase of population, the deaths would have been, not 429, but
18,752. The net gain in life saved during the ten years, therefore'
was represented by 18,323 lives. In other words, had the average
death-rate from small-pox in the ten years, 1871-80, continued
throughout the ten years, 1887-96, 18,323 lives would have been
sacrificed in addition to the 429 which were actually lost by death
*Monthly Report No. 10 1892, page 126.