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in separate wards should be allowed such accommodation, on
paying for it; in case of ordinary accommodation, it appears
to us a question whether payment should be claimed even
from those who can make payment without difficulty.
"If the sick person cannot be removed or isolated by those
about him, the Medical Officer will be bound to take all
necessary steps for his isolation and generally for the
protection of the neighbourhood, with power to clear the
house of its inmates. In all cases he will be bound to disinfect
the house, and in the case of houses invaded by Small
Pox, should be empowered to require the re-vaccination of all
occupants who are not otherwise protected.
"We are led by the concurrent evidence of several experienced
witnesses, to hope that the immediate and complete isolation
which ought to be secured by these means will greatly
diminish the amount of Small Pox, Scarlet Fever, and Typhus
in London. With regard to these, and also Typhoid, still
further diminition may be anticipated if the attention of the
proper authorities is directed to the removal of all local
causes of disease, and to the constant employment of means
of disinfection. And we feel bound to repeat our conviction
that Small Pox would still further be reduced if vaccination
could be made more effectual, and re-vaccination more
frequent. But in what follows we take little or no account
of these reductions. How far our recommendations will,
from this cause, be in excess of what is eventually found
necessary is a mere matter of conjecture. We hope they may
prove considerably so. Meantime this uncertainty is a reason
for proceeding somewhat tentatively.
"Subject, therefore, to what may be expected from the above
or other preventive measures, we think it would be advisable
that there should be sites and buildings which could without
difficulty, be made capable of receiving 3000 Fever Patients,
and 2100, or by special exertion, 2700 Small Pox Patients.
"Of the 3000 Fever cases, those in the earlier stage, probably
about half, should be provided for in the neighbourhood
of London, the other half, the convalescents, in two or three
of the country hospitals.
"The existing hospitals of the Metropolitan Asylums Board.