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51
the ward to say "Good Night," without change of clothes.
I quote this statement, by permission, to show how difficult
it is to get nurses to obey regulations.
Mr. Power, as already stated, admits that at the critical
period in his inquiry there was an excessive amount of personal
communication, with the outside, and from the outside, going on
—there is nothing to suggest that it was unusual or anything
but every day custom—and this is what he says regarding
the communicability of small-pox by personal communication.
It can be "readily transmitted to others by persons who have been
in close relation with the disease, though they themselves may
not suffer from it:" it may be transmitted "in clothing,
parcels, &o," and it is capable beyond other diseases of "infecting
susceptible persons after the briefest exposure to its contagion"
These by no means exaggerated statements going to
show the necessity of absolute isolation of persons brought into
contact with small-pox patients, can it be justly said that
the facts cited by Mr. Power himself bear out the further statement
that "the current doings of the hospital" were "regulated
with the express purpose of avoiding all needless communication
with the outside ?". To my mind they rather suggest the idea
of an infected ship in quarantine, to which visitors are admitted,
and from which officers and crew are allowed to go out at discretion.
Under such circumstances would the spread of disease
from ship to shore excite surprise, or would it be reasonable to
set it to the score of aerial infection ? In my humble opinion the
question whether small-pox can be spread without personal communication,
say at a thousand feet distance, can never be satisfactorily
settled until proof of spread without possibility of such
communication has been given.
The facts stated by Mr. Power do no more than raise a
suspicion that infection may have been disseminated through the
atmosphere: they do not exclude the probability of personal
communication as the starting point in the spread of disease
in the surrounding district. On the other hand, there are
striking illustrations of the fact that if personal communication