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tions imposed on their action by the compromises in regard to the
North-Western and Western hospitals, and by the recommendation
of the Royal Commission that not more than 30 to 40 small-pox
cases should be treated at any one time in a hospital within the metropolitan
area. During the epidemic of 1881, the Managers had
accommodation at their disposal in the metropolis for 1,000 smallpox
cases, and the Camp Hospital at Darenth provided for about
650 cases; 1,650 beds in all—the maximum number occupied at
any one time in the course of that not very extraordinary
epidemic. The Managers, as at present situated, and apart from
the Camp, possess accommodation for 650 cases only, viz., 250
beds in hospitals on land, 50 in each of the five existing hospitals, a
maximum of which they would be reluctant to avail themselves,
and about 400 on shipboard, so that without the Camp there
would be a deficiency to the extent of at least 1,000 beds in the
event of an average epidemic.
To supply this deficiency, the Managers propose, with the
sanction of the Local Government Board, to erect at Darenth a
hospital for 1,000 patients in ten groups of buildings, each to
afford accommodation for 100. Six only of the groups are to be
erected in the first instance, but with all the administrative buildings
necessary for the complete hospital. Each of the groups will be
sub-divided into four wards of 25 beds each, with a day room, &c.,
and infirmary accommodation will be provided for 60 patients in two
large wards of 24 beds each, and two small wards, or isolation
rooms, of six beds each, for the treatment of cases of erysipelas or
other complications occasionally attendant upon small-pox.
Even with this large addition to the Managers' resources, the
permanent provision of hospital accommodation for small-pox falls
short of the requirements of the metropolis, as estimated by the
Royal Commission on Hospitals, who were of opinion that there
should be sites and buildings which could without difficulty be
made capable of receiving 2,100, or by special exertion 2,700,
small-pox patients. The sites are adequate in mere acreage, as
on the land at Darenth any necessary number of tents could be
pitched on an emergency; but the Local Government Board have