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73
Past experience possibly may help us to an answer to the
question just propounded. In the early months of 1881
small-pox was rampant in London, the hospitals were full and
many cases had to be treated at home for want of room. At about
the middle of May pressure was relieved by the opening of the
Darenth Convalescent Camp Hospital; but the hospitals in town,
which contained about 1,000 beds, were kept filled with new cases
as fast as recovering cases (called "convalescents") could be
transferred to the Camp. All cases in that year were first sent to
a hospital in London, and transferred, when convalescent, to the
Camp or to the Ships. There was thus a great amount of movement
of small-pox cases in the vicinity of the hospitals after
Darenth was opened, with the result that the epidemic continued
to increase for several weeks, there having been no sensible reduction
in the number of cases admitted into hospitals until the end
of June. The effect of the system of "direct" removal of cases to
the Hospital Ships, initiated in June, 1884, was to diminish
largely the amount of convergent and divergent small-pox traffic
in the vicinity of the land hospitals—with what results in regard
to small-pox prevalence at Hackney has already been shown.
Similar results followed in other districts on the commencement of
the system of direct removals, but no other hospital had approached
the Eastern in the number of cases admitted. It need hardly be
said that small-pox traffic increases indefinitely the opportunities
for infection, and it is more than probable that it is the explanation
of the spread of small-pox in the vicinity of hospitals,
and of the continuance of epidemic small-pox in London. We
know that when opportunities for contact by personal communication
are reduced to a minimum, as in cases to be referred to of
public institutions under efficient control, then small-pox does not
prevail, even when such institutions are well within the (supposed)
"striking distance" of the small-pox poison. It may be said
generally that if you can stop personal communication you will
stop the spread of small-pox.
The Asylums Board have published a return of cases admitted
at the hospitals during the quarter ended Daeember 31st, 1884,
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