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It must also be remembered that many cases are kept at home, under the observation of the
doctor for a week or more, before a diagnosis of Small-pox is made. This delay as in several of our
recent cases has been the cause of the spread of the disease to other members of the household and
probably to other persons as well.
These facts show that in many cases it is impossible to diagnose Small-pox at the first
examination.
The Medical Superintendent of the Hospital Ships, Dr. Ricketts, in his report for last year,
1900, states that all cases which may possibly be Small-pox ought to be at once notified and removed
to the Shelters until a definite diagnosis can be made.
Under existing conditions I quite agree with him, but think that if the Board were to appoint
an expert or experts to visit suspected cases at their own homes, as was arranged for plague, the removal
of many patients to the Shelters would be prevented.
Although no part of my duty, I have always willingly examined with the doctor cases of
small-pox or suspected cases, and have advised the removal at once of all cases that I thought were
probably small-pox to the Shelters for definite diagnosis.
About a month ago I called on the Chairman of the Metropolitan Asylums Board, and
informed him that I thought it desirable that the Board should make it known that they would
accept the notification of suspected cases, and would remove them to their shelters, and suggested that
increased accommodation for such cases should be provided at the Wharf or elsewhere.
I also suggested to him that an expert should be provided for the prompt examination of
suspected or doubtful cases at their own homes, as doctors generally are afraid to notify such cases as
small-pox, lest they should be returned home as not small-pox.
The notification of chicken-pox has already been adopted by the St. Pancras Council, and by
the City Corporation for the Port of London.
PLAGUE.
No notification of Plague has been received. As stated in my last Annual Report, in accordance
with the regulations of the Local Government Board, dated the 19th September, 1900, Plague was
made a notifiable disease, and a printed circular was at once prepared and sent to each medical
practitioner practising in the District giving information of this.
If any case of Plague occurs on a vessel, the Port Medical Officer of Health on its arrival
sends the names of the passengers and the addresses to which they are proceeding to the respective
Medical Officers of Health.
Information of 20 such passengers was received by me last year. They were each visited, and
17 were found to be in good health ; the remaining three went to other addresses as the hotels were
full, and no further information was received.