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The Sanitary Authority themselves should, on any appearance of small-pox
within their district, at once proceed (under the powers of the Public Health
(London) Act, 1891) to see that proper means to prevent the spread of the
disease by ISOLATION OF THE SICK AND BY DISINFECTION
OF INFECTED HOUSES AND THINGS, are adopted. Any
extension of the disease from the house first infected, or, any fresh
importation of it, needs to be dealt with in the same way. And as, from
the extreme infectiousness of small-pox, every new case is a fresh source
of danger, it is of the first importance towards preventing the spread of
the disease that the necessary measures of the kind above-mentioned should
be taken in each case at the earliest possible moment. Hence it is
important for every Sanitary Authority to see that their Medical Officer of
Health is kept informed, as completely and promptly as possible, of all
cases of small-pox occurring in the district. The knowledge obtained
through notifications received under Section 55, Public Health (London)
Act, 1891, should be supplemented by information procured by house to
house inquiry in each locality invaded as to cases of modified small-pox
that may have escaped recognition or treatment, and by immediate notice
from the District Registrars of all deaths from small-pox*
The hospital treatment of small-pox cases in London under ordinary circumstances
devolves upon the Metropolitan Asylums Managers, who, under
Section 80, Public Health (London) Act, 1891, subject to such regulations
and restrictions as the Local Government Board prescribe, may admit any
person who is reasonably believed to be suffering from small-pox into a
hospital provided by the Managers. The expenses incurred by them for
the maintenance of any such person are to be paid by the Board of
Guardians of the Poor Law Union from which he is received, but are
repayable to the Board of Guardians out of the Metropolitan Common Poor
Fund. The admission of a person suffering from an infectious disease
into any hospital provided by the Metropolitan Asylums Managers, or his
maintenance there, is not to be considered parochial relief, alms, or charitable
allowance, and does not entail loss of any right or privilege, or involve
any disability or disqualification.
The Metropolitan Asylums Managers are also empowered by Section 79 of the
Act to provide ambulances for the removal of patients.
The following are the measures which Sanitary Authorities should take:—
1. It is of great importance that all persons suffering from small-pox, and
so lodged that the isolation of them from healthy persons cannot be secured
* It must always be remembered that small-pox is liable to be spread by infection, not only from
well-marked and easily recognised cases, but also, as indeed frequently happens, from cases of which
the nature is not at first evident, especially to medical men unfamiliar with the disease. Such
attacks may be, on the one hand, mild and modified cases, which may be mistaken for chicken-pox
or other comparatively slight disorder ; or, on the other hand, they may be hemorrhagic or other
malignant and rapidly fatal forms in which death may occur before the characteristic rash has had
time to develop itself.