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the views of the leading Managers, supported as these were by
the somewhat tardily given advice of the Local Government
Board, soon silenced the opposition, and thenceforth accommodation
was provided, as required, by the erection of '' huts"
in the grounds of some of the hospitals—the work being carried
out with much celerity, and at no small expense, so that not a
single patient was denied admission. The Managers, moreover,
with a boldness which elicited the approval of all competent
authorities, threw open the doors of their hospitals, removing
thereto large numbers of patients, upon the application of
medical practitioners, without the formality of an order by a
relieving officer. The Local Government Board raised no
objection to this proceeding—contrary as it was to their Order
regulating the admission of patients, which necessarily follows
closely the provisions of law. The Board even facilitated the
practice by issuing, at the request of the Managers, an Order
which legalised the certificate of the private medical practitioner
as evidence of the nature of the disease—a concession of value,
for which I had pleaded eleven years previously. But, as we shall
see, the Board stated that, as the law stands, they have no power
to comply with an application "for authority for the Managers to
remove all persons suffering from fever or small-pox, whose
removal shall be applied for by duly qualified medical
practitioners."
The type of scarlet fever was, as I have said, mild, the
case-mortality in the Hospitals being low. In Kensington the
mortality in respect of known cases was 9.4 per cent., a rate in
excess of the true proportion as many cases doubtless occurred
of which we had no information. Still, we have reason to
believe that notification is much more general now than in
byegone years. Thus, comparing 1887 with 1880, we
note that the number of cases recorded was the same in both
years, but the case-mortality in 1880 (22.5 per cent.) was more
than double that in 1887; and the only conclusion at which we
can arrive is that in 1880 the concealed cases must have been
considerably more numerous than in 1387. The deaths in