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52
be excluded, small-pox does not spread at even moderate distances,
and to these the Hospitals Commission allude at page 26
in their report. The strongest case in point is that of the
Infirmary of the City of London Union at Homerton,
cited by Dr. Collie. The windows of this institution
are within a hundred feet of the windows of the Homerton
Small-pox Hospital, and yet small-pox has never spread from
the hospital to the infirmary, there being no means of personal
communication between the inmates of the two buildings.
Small-pox has spread around Homerton Hospital in other
directions, but under circumstances of which an essential
feature was the opportunity afforded for personal communication
or contact. Around this hospital, moreover, the originally
open ground has been covered with buildings up to the walls.
Fulham Hospital, on the other hand, is wonderfully well
isolated, being surrounded on every side by large open spaces.
The nearest houses in Kensington are at a distance of some
800 feet from the boundary fence of the hospital site, and
separated from it by the width of Brompton Cemetery, which
is full of trees. These nearest houses however, are in Ifield
Road, and in this street there have been more cases of smallpox
than in any other—a fact that has impressed the public
imagination, being held almost to prove the dissemination
of infection through the air from the hospital: in 1881 there
were more cases than ever, but the disease disappeared months
before the hospital ceased to receive "acute" cases. The
instructive facts with regard to small-pox in this street, in 1881,
were fully set out in my evidence before the Hospitals Commission:
with what effect may be inferred from the statement
in their report that they ''lay no stress" on "an
outburst in Ifield Road, which has occasioned so much
controversy in relation to Fulham Hospital." And yet
probably there were more cases in this street (42) than in all
the remaining streets within a quarter mile of the hospital.
The next largest number of cases occurred in Finborough
Road. This street is in part a continuation of Ifield Road, and