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12
Moreover, during 1884, the admirable ambulance arrangements
of the Metropolitan Asylums Board came into force, and
the opportunities for the dissemination of Small Pox through
defects of ambulance administration were reduced to a minimum.
Again very considerable precautions were taken to reduce the
visiting of friends to patients in the hospital, and the spread of
infection through the outgoing of nurses and hospital servants,
yet, notwithstanding these precautions, the distribution of the
disease has been such that it is difficult not to believe that the
Small Pox Hospital at Hampstead has, in some way or other,
been the cause of Small Pox in St. Pancras houses situated near
to it. After careful consideration of all the circumstances
connected with the outbreak of 1884, I have felt that such
knowledge as I have concerning the Hampstead Hospital
and the distribution of disease around it, does not warrant
me in expressing any definite opinion on the question
whether the disease was spread through personal communication
or was aerially diffused. Before such opinion
could be formed it would be necessary to study all the facts in
connection with the distribution of Small Pox in the total area
round the hospital, and this, as Medical Officer of Health for
St. Pancras has not been possible for me to do.
The next point for consideration is the distribution of Small
Pox in the neighbourhood of the Highgate Small Pox Hospital.
This hospital is situated in the Parish of Islington a few yards
"west of the boundary of the Parish of St. Pancras. The portion
of St. Pancras Parish which is nearest to the hospital is not
thickly covered with houses; they are of small size, and are not,
therefore, occupied by a large number of persons. Access to
the hospital can be obtained by an entrance gate on the boundary
of St. Pancras Parish, as well as on the other side of the
hospital, in the Highgate Road, and the details of administration
of this hospital differ in some respects from those of the
Hampstead Hospital. The patients moreover, are, as a rule,
conveyed to the hospital in private ambulances, which are not
under the control of the hospital authorities.
The distribution of Small Pox in the neighbourhood of the
Highgate Small Pox Hospital will be understood by reference to
the charts which accompany this report, and to the following
table: