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(15). "This will provide for those cases which cannot be sent down the
Thames. But we concur with Sir. W. Jenner and Sir E. Currie in thinking
that others—and in years of severe epidemic a larger number—might be sent
down the river to hospitals in isolated situations on its banks, or if this is
found impracticable, to floating hospitals on the river itself. For this opinion we
have already given our reasons.
(16). " It is plain that under these circumstances small-pox or fever hospitals
supported by parishes or unions, like those at Finchley and Plaistow, will become
superfluous, and they will probably be disused unless either of them should prove
available as hospitals of the Asylums Board. Concerning hospitals supported
wholly or in part by charity it was not within our duty to inquire, except in so
far as facts observed in them might help to elucidate the questions put before us.
It seems only right to record that we received evidence of excellent management
both in the Small-pox Hospital at Highgate and in the London Fever
Hospital at Islington. We do not doubt that both these institutions have done
excellent service to the public by their care of the sick, and in diminishing the
risks of infection, by taking many from houses in which they could not be duly
isolated. But we think it very doubtful whether the establishment of other
hospitals of the same kind, either as charitable institutions or as places of
reception for those who can pay, should be allowed unless they are to be subject
to the general but effective supervision of the sanitary authority.
(17). " The foregoing suggestions are calculated to meet in some degree the
intermittent character of small pox visitations. If the hospital authorities had
only to do with small-pox, they would have to collect a staff on occasion of each
epidemic, and, if they did not wish to retain it in idleness, to break it up when
the epidemic was past, just as it had effectually learnt its work. The experienced
officers being thus in a great measure lost, a fresh, and, from the nature of the
case, a less perfect machinery would have to be created when the next emergency
occurred. The comparatively permanent fever establishments, however,
will supply something in the nature of a cadre, which it will be comparatively
easy to expand by the temporary engagement of fresh officers when the smallpox
visitation arrives, and to reduce when it is past.
(18). " With regard to matters of detail we have already recommended that
the hospital authorities should have the entire control of the ambulances, by
which all other modes of conveyance should be as far as possible superseded ;
that the regulations intended to prevent the communication of infection by visitors
should be strictly enforced; that the entrance appropriated to the sick should
be entirely separate from that of the tradesmen, contractors, and others; that
letters should be carefully disinfected ; that the nurses and attendants should
not be permitted to leave the hospital except at longer intervals, and for proportionately
longer periods; that great care should be taken respecting the exposure
of infected clothes or bedding ; and that the greatest attention should be paid to
the state of the drains in and around the hospital. To all these