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40
The above subject is not the only one in regard to which,
difference of opinion has arisen between the Local Government
Board and the Managers in connexion with the question of
hospital accommodation, the two Boards being at variance as to
the proper method of providing for small-pox cases at nonepidemic
periods like the present. On grounds of economy,
mainly, the Board urges the Managers to close the Hospital Ships
and treat patients at the several London hospitals. Regarded
from the standpoint of the Board, as a Poor-Law Authority, the
advice may be sound, although in fact the Managers claim
economy as a further recommendation of their own plan of
making almost exclusive use of the Hospital Ships. But the
Board is also the Central Sanitary Authority, and possesses, in
the Medical department a highly efficient staff, accustomed to
look at health questions from a purely sanitary point of view.
This Medical dspaitment is committed to the opinion, which has
a great deal to support it—whether we agree or not with the
premiss on which their conclusion is mainly founded—that smallpox
hospitals are a source of danger to surrounding districts. In
his latest report on the Western (Fulham) Hospital, Mr. Power
states:—
" That the excess of small-pox in the neighbourhood of the hospital was
quite and specially remarkable at a time when the total admissions to
hospital had not exceeded nine—"
a "new experience" concerning which Dr. Buchanan, Medical
Officer to the Board, observes that " of the facts upon which the
remarkable conclusion is based, and of the validity of the inference
from the facts, there cannot be (he thinks) any question." The
"conclusion" will appear more remarkable when it is known
that the incidence of small-pox in the " Special Area "* to which
Mr. Power refers, occurred at a time when there were only five
patients in the hospital, which is well isolated and at a great distance
from the houses invaded; that no such marked "excess"
was observed with subsequent increase of numbers, to a maximum
of 35, and that the treatment of five and seven acute cases
* Special area = circle drawn round the hospital having a radius of one mile.