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14
SANITARY CHRONICLES, 1895.
Towards the end of September, difficulty began to be
experienced in removing cases to hospital. The Asylums
Board accommodation was practically exhausted; this was
partly, it appears, from a large increase in the cubic space
per head allotted to each patient. The Medical Superintendents
had found, by careful observation, that in
scarlet fever and diphtheria the success of treatment, the
rapidity of recovery, and the absence of certain sequelae had
a distinct relationship to cubic space: every 100 patients
treated in very roomy wards recovering quicker, and so to
speak more happily, as compared with 100 patients under
not quite such good conditions.
Accordingly, what has been described as an excessive
amount of air-space was given to each of the patients; this
necessarily decreased considerably the accommodation. On
the other hand, the writer has urged that, of the two evils,
viz. : the keeping of patients in crowded tenement houses,
under conditions which admit of no effective isolation, and
the decreasing of the cubic space for a short period in
hospitals, the latter evil is infinitely the better of the two,
and saves more lives and sickness, with its consequent
misery and poverty. Besides this restriction of accommodation,
the Managers had reason to be apprehensive of
outbreaks of smallpox. The St. Marylebone experience
of the Portland Town outbreak had taught them the lesson
that smallpox might burst suddenly at any period of the
year, and assume formidable dimensions, especially in such
a vast concourse of persons as comprise the population
they have to provide for. Consequently the Gore Farm
Hospital was kept unoccupied, ready for the contingency of
smallpox. A number of temporary buildings were also
being altered to more permanent structures. By statute,
the Managers cannot refuse to admit anyone who is a
ratepayer in the Metropolitan District. The people of
London have no horror of hospitals; the Asylums Board
Hospitals have become in a way popular; the consequence
is that they are insufficient in number and size to deal
effectively with anything but the infectious disease of very
ordinary years. It is a question whether even those which
are now in course of erection will not be still found
insufficient.