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ments of the metropolis, the sick might be sent down the river
to hospitals in isolated situations on its banks ; or, if this be
found impracticable, to floating hospitals on the river itself.
This proposal appears to have commended itself to the Local
Government Board, which, under the vigorous initiative of its
new President, Sir Charles Dilke, recently addressed a communication
to the managers, recommending the provision of
" one or more floating hospitals, in addition to the Atlas," on
the Thames, some 15 miles or more below London Bridge,
" where the less acute cases of small-pox might be received."
" Probably," they say, " land at no great distance from the
hospital ships could be secured for the erection of buildings to
which convalescent patients could be transferred." A steamer,
with adequate appliances for the immediate treatment of the
sick, would have to be provided for the conveyance of patients
down the river, and " suitable places on the banks for the
transfer of the patients from the ambulances to the steamers
must be found." If the managers should be unable to secure
such embarking places by voluntary arrangement, and if compulsory
powers of purchase should be required, the Board would
be prepared to consider the question of proposing legislation
for conferring such powers on the Managers. No specific
reference is made to the subject of additional accommodation
for fever cases, the Board probably considering that when the
existing hospitals (minus the beds to be reserved for small-pox),
can be wholly devoted to this class of cases, the accommodation
will prove sufficient for acute cases, at any rate ; the question
of convalescent homes standing over. The Board conclude by
assurances of their " desire to assist the Managers as far as
practicable in meeting the difficulties with which they have to
contend, and in securing the additional hospital accommodation
which appears to the Board to be essential to the satisfactory
discharge of the responsible duties with which the Managers
are entrusted." The Managers lost no time in acting on the
recommendation with regard to the ambulance, a design of a
vessel having been prepared, and approved by the Local Govern-