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Asylums Board should make provision for dealing with all suspected cases of plague in London,
if the Local Government Board think fit to transfer this duty from the Council to the Asylums
Board, and that the Asylums Board be informed of the Council's resolution in the matter; and,
further, that the Public Health Committee be instructed to report upon the control and treatment of
" contact" cases.
Letters were accordingly addressed to the Local Government Board and the Metropolitan Asylums
Board, and on the 11th instant the Local Government Board intimated that after consideration of
all the circumstances they had asked the Metropolitan Asylums Board to undertake the duty of
dealing with suspected cases.
With regard to the Council's instruction to us to report as to the control and treatment of "contact"
cases, we may point out that the duty of dealing with these cases was undertaken by the Council
in October last at the suggestion of the Local Government Board, that a number of premises in
different parts of London have already been prepared for the isolation of these cases, and that the
Council has authorised us to expend, if necessary, a sum not exceeding £50,000 upon these and
other precautionary measures. The object of isolating all persons who come in contact with plague
cases is to enable them to be kept under medical observation until the period of incubation has passed.
They are healthy persons and do not therefore require nursing or special treatment, and it is not
proposed that they should be prevented from following their usual occupations. All that is desired is
that they shall live in the isolation homes and be medically examined each morning and evening, in
order that should symptoms of plague develop they may be at once detected and removal to hospital
effected without delay.
Experience has shown the extreme importance of the early isolation of these "contacts," and the
recent epidemic in Glasgow was stamped out by the adoption of this and other precautionary measures.
The Council has no power to compel the isolation of persons who may have been in contact with
plague cases, but in Glasgow little difficulty was found in inducing such persons to use the isolation
homes. We propose that food shall be provided, that the clothes of the inmates of the homes shall
be washed in a laundry to be purchased by the Council for the purpose, and that, while this is being
done, clothing shall be lent them by the Council.
We think that the Council is the proper authority to make provision for these people, and that,
as they are not sick persons, they do not come within the sphere of operations of the Metropolitan
Asylums Board. Moreover, we have no reason to believe that the Board desire to deal with these
"contacts" as they will, in the event of any serious outbreak of plague, have sufficient work to do
in treating actual and suspected cases.
The following statement shows in detail the procedure which will be adopted in conjunction with
the Metropolitan Asylums Board on cases raising suspicion of plague becoming known—
On receipt by the London County Council of intimation from any medical man that any
person in London is suffering from a malady raising suspicion of plague, the Council's plague
expert will be requested immediately to visit the patient.
He will decide whether the patient should be removed to one of the hospitals of the Metropolitan
Asylums Board—
(а) As a suspected case of plague.
(b) As an actual case of plague.
If he is of opinion that the patient should be removed, he will communicate with the Metropolitan
Asylums Board with this object in the manner provided by the regulations of the managers,
stating whether the patient is to be deemed a suspected or an actual case of plague.
He will write a certificate as to the nature of the case and leave it in a closed envelope with
the patient's friends, to be given to the ambulance driver when he comes to fetch the patient.
In the case of every patient to be removed to hospital, either as a suspected or actual case
of plague, he will take material for bacteriological examination and send it immediately to the
County Council's bacteriologist.
In all other cases he will use his discretion as to whether he shall take and send such
material.
He will at once report to the county medical officer of health as to every case and the course
he has taken.
The County Council's bacteriologist will report the results of his examination to the county
medical officer of health, who will at once inform the medical officer of the Local Government
Board, the clerk of the Metropolitan Asylums Board, and the medical officer of health of the
district of these results.
In the event of a case of actual plague occuring, if the removal of "contacts" to one of the
Council's shelters is desired, arrangements will be at once made by the county medical officer of health
for this purpose. Persons in contact with suspected plague will, pending decision as to the nature of
the case, not be removed to a shelter unless the circumstances of the case are altogether exceptional.
The Metropolitan Asylums Board will not remove any suspected or actual case of plague except
on the certificate of the County Council's plague expert. The certificate of the Council's bacteriologist
is to be accepted for this purpose.
The certificate may be signed by the expert only, or by any medical practitioner and countersigned
by the expert.
The Council approved the arrangements made by the Committee. Buildings iu the possession
of the Council were prepared for occupation, furniture and clothes being provided for this
purpose. There was, however, only one occasion on which any of the Council's shelters were used.
This occasion was in the month of April, and the circumstances of the case will be found among
those of others which were inquired into during the year.
Meteorology.
The tables published in the Annual Summary of the Registrar General, prepared by Mr.
J. Glaisher, F.R.S., from observations at Greenwich, show that the mean temperature of the
air in 1901 was 49 2° Fahrenheit, or 0 3° above the average of the 130 years 1771-1900. The
rainfall during the year amounted to 20'28 inches and was 4.52 inches below the mean of
86 years.
The temperature and rainfall in each month of 1901 are shown in the following table—