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101
As respects " Fever," nothing happened, prior to 1S87, to
lead the Managers of the Asylums Board to think that they
would be likely to require so many as 3,000 beds, and the only
step taken by them towards giving effect to the recommendation
of the Commissioners, was the erection of the Northern
Convalescent Fever Hospital, at Winchmore Hill, for about
480 patients. In 1887, however, an epidemic of scarlet fever
tasked their resources to the utmost. Not only were all the
available beds filled, but a large and costly addition of
temporary huts had to be run up in the grounds at several of
the hospitals; and the "Poplar" Hospital, at West Ham, was
also brought into requisition. And yet the deaths from scarlet
fever (1,443), were 381 below the decennial average. The
total number of "fever" patients received into the Managers'
Hospitals in that year, including 5,900 suffering from scarlet
fever, was 6,537, or nearly 4,000 more than in any previous
year: the maximum number under treatment at any one time
was 2,600, or about 700 in excess of the normal accommodation.
The great increase in the number of persons admitted
was largely due to the increased facilities afforded by the
Managers—whose new Regulations, issued in that year, permitted
of the reception of patients upon the application of any
duly qualified medical practitioner—and to an Order of the
Local Government Board, giving effect to a recommendation
I had made in 1875, viz., that the certificate of any duly
qualified medical practitioner should be accepted as evidence
of the nature of the infectious disease. But the operation of
compulsory notification must not be left out of account in any
explanation of the growing disposition of the public to make
use of the rate-supported hospitals; or, I would add, in estimating
the probable requirements of the future. How greatly
these causes, and the depauperisation, in 1883, of medical
relief in the hospitals, which I had been advocating since 1877,
operated to popularise the use of these institutions, may be
inferred from the fact that the admissions of scarlet fever cases
in 1891, when the mortality (589 deaths), was the lowest on