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by the Board, at the end of 1880, that cases of small-pox were
occurring in an exceptional fashion round certain of the Metropolitan
Asylums Board Hospitals, and it was felt that Dr.
Thorne's experience on this subject, derived from hospitals in
the provinces, ought not, without further inquiry, to be
accepted as representing the whole truth for hospitals in
London." The inquiry relating to the Fulham Hospital, made
in the early part of 1881, by Mr. W. H. Power, one of the
Board's medical inspectors, was the outcome of this view.
Mr. Power sums up the results of his inquiry in certain
conclusions, nine in number, concerning which Dr. Buchanan,
the Medical Officer to the Local Government Board (from whose
report the preceding quotations are taken), states he has "no
choice " but to accept them, and to believe that the hospital,
" with all its advantages of site and construction, and
with the many excellences of its administration, has, by dissemination
of small-pox material through the atmosphere,
given rise to an exceptional prevalence of small-pox in its
neighbourhood." "It is to be distinctly noted," however,
that Mr. Power's report " relates to Fulham hospital
only; and it is possible that the circumstances of that hospital
are in some way exceptional, and that its experiences cannot
be taken as true for other London small-pox hospitals."
It should be added that several eminent medical authorities
have, like Dr. Buchanan, accepted Mr. Power's conclusions,
which, in a word, attribute the prevalence of disease in the
district around the hospital—especially at " the commencement
of an epidemic when acute cases are beginning to come in, in
considerable numbers," and under favouring atmospheric conditions—to
" dissemination of small-pox material,'' from the
hospital.
The Hospitals Commission, on the other hand, are of opinion
that "personal communication" would equally well account
for the observed facts. The question to be determined, therefore,
is, whether the first cases of small-pox in the vicinity
of a hospital, asuming them to be due to the hospital, are to