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of single wards, lies lower than the cemetery, and its roof is at about
the level of the top of the cemetery walls. It is about opposite the
centre of Ifield Road, the site being 750 feet in length, and the road
having a length of 2,500 feet. Small-pox cases have occurred in this
road equally on either side, and from end to end of it.
For the block plan of the hospital itself, reduced from the plan published
with Dr. Makuna's last annual report, I am indebted to the
kindness of Mr. H. E. Pollard, a member of your Vestry.
Now if a hospital isolated, constructed, and well ordered as this one
admittedly is, could be proved to be dangerous to the people in its
vicinity, an important question would practically be settled: there ought
to be no hospitals for infectious diseases within the metropolis !
It is remarkable that persons who take this view, who regard
the hospital as a common danger, and would close it forthwith, yet do
not appear to regard as anything very serious the risk of keeping smallpox
patients at home, in rooms that are small and unventilated, in houses
that are tenanted by numei'ous families, and under conditions which
would neutralise the best attempts at isolation, but where, practically, no
such attempts are seriously made. In such circumstances patients are
kept at home, and it has been my lot to see disease spread from family
to family without direct contact between the sick and well. How,
indeed, could it be otherwise? If the "infectious particles" can be
carried by the air hundreds of yards from the hospital as alleged,
a fortiori: they can be carried from one room to another by the air in
the common staircase; and from house to house, from street to street 1
And if nurses, visitors, &c., may convey the disease from the hospital
as stated, notwithstanding all the precautions taken to avoid the spread
of infection ; how much greater must be the danger arising from those
who, after contact with the sick, without bathing and without change of
clothing or other precautions, mix with their fellows in the outside
world ?
Many a case is kept at home simply because the attack is slight ;
and medical advice is not sought lest the removal of the patient should
be enforced: scarcely any precautions are deemed necessary. The man
who does not feel ill will not readily submit to enforced idleness, which
means starvation for his family; while the convalescent child, in such
circumstances, thought to need fresh air, is turned out to get it in
the streets. Rarely does it happen that home-patients are isolated for