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that it was desirable that every medical officer of health in London should at once learn to
which institution any such cases occurring in his district could be removed. The secretary
of the Local Government Board thereupon requested the medical officer of that Board to
communicate with the London medical officers of health, and letters to these officers were
despatched the same day.
It being obvious that, apart from the duties of the port sanitary authority, the most
pressing need was the organisation of the arrangements of the Metropolitan Asylums Board,
and, having been employed by that Board in 1885 when the circumstances were similar, I
obtained the leave of the chairman of the Council to offer my service to the managers.
This offer was accepted, and I have since been employed in rendering such assistance as
I could to the Cholera Committee of the Metropolitan Asylums Board.
On the 25th of August three cases of cholera had arrived at Gravesend in the Gemma,
a vessel containing poor Jewish immigrants who had embarked at Hamburg. These cases
were removed by Dr. Collingridge, the medical officer of the port of London, to the hospital of
the port sanitary authority at Gravesend, and subsequently the rest of the passengers of this
class on board that vessel were similarly dealt with.
The removal of the sick had been effected under the General Cholera Order of the Local
Government Board, of the 28th of August, 1890, which also requires the Medical Officer of
the Port to record the names and addresses of other persons on board the vessel for the
purpose of transmitting this information to the sanitary authorities of the places of destination.
The Order gave no authority for similar action in respect to passengers on board vessels
not affected with cholera ; but the short time occupied in the journey between Hamburg and
London (30 to 40 hours) made it probable that cases of cholera would thus be introduced into
the metropolis, and particularly by the poor Jewish immigrants who were arriving in
considerable numbers. As matter of fact, I learnt on the 29th August that the Portia, the
sister ship to the Gemma, and containing passengers of this class, had already, on the 27th
August, been passed by the port authority, no cases of cholera having been known to have
occurred on board.
It was evidently very necessary that the names and addresses of all such persons arriving
in London should be taken, and, after visiting Gravesend and conferring with Dr. Collingridge,
I summoned the Council's inspectors, and stationed them (on the 29th August) at the docks
where these vessels might be expected, providing them with interpreters, and instructing them
to take the names and addresses of all persons arriving from Hamburg.
The same night an Order was issued by the Local Government Board extending the
powers of port sanitary authorities and enabling them to deal with passengers in a filthy or
unwholesome condition arriving from infected ports, and irrespective of the question whether
cholera had occurred on board the vessel, and subsequently on learning from Dr. Collingridge
that he was prepared to carry out this duty, on the 31st of August I recalled the Council's
inspectors.
Dr. Hamer, at my request, called upon the principal shipping firms bringing passengers
from Hamburg,with a view to learning whether they were willing to take and communicate to
the Council the names and addresses in London of all passengers travelling by their boats
from infected ports. Dr. Hamer was informed these firms would be willing to do so if asked
by the Council. This step has, however, not been necessary, as the Local Government Board,
on the 6th September, empowered port sanitary authorities to do what is necessary.
I should also add that I obtained the names and addresses of passengers arriving in
the Portia, who had been distributed about London, and in each instance I communicated
with the medical officer of health of the district in which they had become resident, with a
view to these persons being kept under observation.
In these proceedings I have had the assistance of Mr. Smith, the Superintendent of the
" Poor Jews' Temporary Shelter," 84, Leman-street, Whitechapel, whose knowledge of the
movements of Jewish immigrants, and of the vessels in which they arrive, was of the
greatest value, and I would desire to acknowledge the aid he has given me.
Shirley F. Murphy,
Medical Officer of Health.
The number of deaths attributed to "cholera" during the year was 87, the numbers in 1889
being 62, in 1890, 84, and in 1891, 71. A case of cholera in Lambeth was regarded by Dr. Verdon,
the medical officer of health of that district, as of undoubted Asiatic type. Information of this case
was received by him on Monday, October 3rd, from the resident physician of St. Thomas's Hospital.
The patient, Dr. Verdon writes in his annual report, "occupied the position of a captain in charge of a
river tug plying between Woolwich and Beckton, and his business consisted in loading, unloading and
towing from place to place the cargoes of ships. Usually his engagements prevented him from visiting
home more frequently than at weekly intervals. On the evening of Friday, two days before his
admission into the hospital, he arrived home and complained of feeling unwell. Refusing food, he went
to bed ; on Saturday morning he left home for business; on Saturday evening at 9 o'clock he returned.
At this time his symptoms were acute, his wife became alarmed, and sought the advice of a local medical
practitioner, who visited and prescribed for the patient. The severity of his symptoms increasing, he
was removed to St. Thomas's Hospital at 1 o'clock on Sunday morning." The patient died on
October 7th.
Very complete arrangements were made for the prevention of extension of disease from this case.
The bedding, carpets, window blinds, and wearing apparel in the room occupied by the patient at his
home were destroyed. Quicklime was spread over the earth and stones in the yard where he had
vomited. The house was thoroughly disinfected and cleansed. The other inmates of the house having
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