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100
cases with the utmost attainable rapidity. The committee,
determined that no avoidable delay should take place, resolved to
admit cases of small-pox and fever into the hospitals upon the
direct application of any duly registered medical practitioner, and
without a previous order of a relieving officer. Applications were
to be made at the chief offices of the Board, Norfolk Street,
Strand, by telegram, during the hours telegraph offices are open,
on week-days only. The offices are in telephonic communication
with all the hospitals, and immediately on receipt of a telegram an
order is sent to the Superintendent of the Ambulance Station of
the district, who, despatches an ambulance with a nurse to remove
the patient. The details of the scheme are set out in the
" Regulations of the Board for the removal of cases of Small-pox
and Fever by the Land and River Ambulances," (June 21, 1884).
Information of cases so admitted is sent to the Clerk to the
Guardians, and, in accordance with my suggestion, every case is
reported to the Medical Officer of Health also, so that he may
take proper measures for disinfection, &c.
Such an admirable plan was impossible of execution while the
ambulance arrangements were under the control of numerous local
authorities, but it became practicable when the Board decided to
undertake the duty of removing the sick over the entire area of
the Metropolis. In this connexion I may mention that the
Western District Ambulance Station, adjoining the Hospital at
Fulham, being now in use, applications for removal of cases to
that hospital between the hours of 8 p.m. and 8 a.m., and all day
on Sunday, are required to be sent to the Ambulance Superintendent
direct. To facilitate the working of the new system,
the Guardians, at my suggestion, resolved to place their offices in
direct telephonic communication with the offices of the Board. I may
add that I communicated the above information as to the facilities
for the removal of cases to the medical men throughout the parish,
and supplied them with copies of a suitable form of certificate, &c.
I also informed them that your Vestry would reimburse the cost of
the telegraphic application for removal in the case of any patient
unable, through poverty, to pay for it.