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to the number of 2,186 (Table L, page 75), and in that return there
is no evidence of excessive prevalence of small-pox in the parishes
in which hospitals are situated. On the contrary, the disease was
far more prevalent in parishes which contain no hospital, than in
parishes situated within the "special area" of hospitals. It is
impossible, however, for any one but the local Medical Officer of
Health to say whether the proportion of cases in the immediate
vicinity of a hospital is excessive as compared with other parts of
the district. If it is excessive near the hospital, and not elsewhere
in the same parish, the fact would seem to show that small-pox
traffic is in some way the cause of small-pox spread. I do not
mean to say or to suggest that the disease is spread by the patients
in the ambulances, though spread in that way is possible, and even
probable, on the "short diffusion" theory, but simply to point
to the desirability of limiting as much as possible the concentration
of small-pox traffic in the vicinity of hospitals on the ground that
the thicker the line of such traffic in any district is, the greater the
danger will there be of the spread of disease in that district.*
Dr. Bristowe, Medical Officer of Health for Camberwell, has
on more than one occasion reported an excess of small-pox in the
vicinity of the South-Eastern Hospital (at Deptford), which may
well be due to small-pox traffic, as "Ward No. 4," where the
disease prevails most, is traversed by the Old Kent Road,
by which access to the hospital is obtained from all parts.
* Taking the figures in the above-mentioned return in the gross it appears
that in the "East District"—population roughly 700,000—there were the most
cases, viz., 845 out of the total of 2,186. There is no hospital in any of the
parishes comprised in this district. In the North District the cases were 579
only in a population of about 900,000, there being in this district three hospitals,
the "Higligate," the "North-Western," and the "Eastern," situated in the
parishes of St. Pancras, Hampstead, and Hackney. St. Pancras, Hampstead, and
Hackney contributed 182, 56, and 147 cases respectively; Marylebone, 40; and
Islington, 154. The 1,265,000 population of the South District sent in 408
patients, including Camberwell, 58; Greenwich, 89; Lambeth, 72; St. Olave, 34;
and St. Saviour, 92. The South-Western Hospital is situated in Lambeth, near
Clapham. The West District, population 670,000, sent in 189 patients (less
than a fourth of the number from the East District), of which number the parishes
of Kensington and Chelsea, and the Fulham Union, comprising the Borough of
Chelsea, contributed 55, 27, and 35 patients respectively (total 117), and Paddington,
St. George's, Hanover Square, and Westminster (combined), 72. The Western
Hospital is at Fulham, near Kensington and Chelsea. The Central District, with
a population of less than 300,000 and no hospital, sent in 165 patients, including
93 from Holborn. The figures are set out in detail in Table L.