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were registered, all in the "Town" sub-district; and the malady,
which assumed serious proportions towards the close of the year, is
at the present time (June) prevailing with almost undiminished
force. In my last report I narrated some striking fatal cases, the
nature of which had unfortunately been mistaken at the first. It
is impossible to say to what an extent the spread of the disease may
be attributed to such oversight, and to the concealment of nonfatal
cases, owing to the want of a national registration of disease ?
But, by way of comparison, to take a disease in the lower animals,
cattle plague, which has lately excited much alarm throughout the
country, does anybody doubt the large proportions this virulent
infectious disease would have attained if the earlier cases had been
overlooked or concealed ? or can anyone doubt the success of the
"stamping-out" process, by which it was so speedily eradicated
? We cannot, of course, "stamp-out" disease in man by the
process applied in cattle disease: but if the law required the disclosure
of every case of infectious disease, and if we had the same
power to deal stringently with infected people and infected houses in
order to prevent the spread of an epidemic, that the Inspectors of the
Privy Council enjoy in dealing with cattle and cowsheds in
epizootics, I, for one, entertain no doubt that a disease like smallpox
would rarely if ever attain the proportions of a serious
epidemic. Our powers are very limited indeed, though we must
thankfully admit the advantages conferred on the Metropolis
through the establishment of hospitals by the Metropolitan
Asylums Board, under the Metropolitan Poor Act of 1867.
Speaking generally these hospitals have been as freely open to receive
the sick whom we desired to send into them as though they
had been under our control;—not of right, but of grace. The
Poor Law Guardians might have declined taking many of the sick
on the ground of their not being paupers, strictly so called;
although they became so by the mere fact of receiving such (nearly
always) gratuitous relief. But they did not do so, and the "Managers"
received all comers without question. I speak of course with
reference to Kensington cases. What has happened in other
parts of London I am not in a position to state, but I have
reason to believe that in some districts there has been some
friction in the relations between Poor Law and Sanitary Authorities.
The possibility of any such friction should be at once removed;
for while conceding the generally satisfactory working of the
dual system, in Kensington, it must be admitted that its success is
entirely dependent on the existence of good feeling between the
authorities; and on the intelligent appreciation by the Board of
Guardians of the necessities of the position. Boards of Guardians,
if they thought fit to do so, might at any moment practically
close the asylum doors against a large proportion of the infected
sick on the plea that they are not paupers. The Local