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39
"The southern and northern groups use the public hospitals in practically
equal degrees, and yet differ much in their small-pox mortalities; but
with this exception the table, as already said, confirms the expectation,
that small-pox mortality is diminished in proportion to the use made of
hospitals. It may be assumed with much confidence that were there no
hospitals at all, even those districts which apparently now Buffer in
comparison with their neighbours, by being the sites of hospitals, would
suffer very much more than they do now. The presence of a hospital
within their boundaries prevents their deriving quite so much benefit as
their neighbours from the hospital system, but by no means robs them of
all the benefit."
Agreeing as I do with the conclusions at which the RegistrarGeneral
has arrived from a study of the mortality, I think it right to
add that the prima facie case against the hospitals, arising out of the
spread of small-pox in surrounding districts, is even stronger than
would appear from his statements, because in the locality around
a hospital there are more cases of small-pox than in other parts
of the same district. Why? Thick and thin opponents of hospitals
assert that germs of disease are disseminated from the hospital
which thus becomes an inevitable centre of infection. Could this
be proved it would not be easy to uphold the hospitals even
admitting, with the Registrar-General, that the balance of good is
much in their favour: it would be deemed unjust to expose people
living in one part of the metropolis to a serious danger for the
benefit of people living in other more distant parts, and the
objection would be nearly as great in respect of local or district
hospitals as in the case of Metropolitan hospitals. But the questions
to be considered are (1) whether the dissemination of small-pox in the
vicinity of hospitals, assuming it to be proved, may not be accidental
rather than inevitable? and (2) whether such alleged dissemination
might not be altogether, or in great measure, prevented by a more
rigid system of isolation? These questions the Hospitals' Commission
are considering, and pending the publication of their report,
now imminent, I do not propose to discuss them. But I may be
permitted to repeat here what I have said on other occasions, viz.,
that small-pox is so virulently infectious, that the less of it kept
within the bounds of inhabited districts, whether in houses or in
hospitals, the better; and as it fortunately happens that a very
large proportion of the cases admit of being removed to any
reasonable distance—the proportion is greatest if removal is