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statement made by the Medical Superintendent of the Hospital
Ships, to the effect that, of the cases then recently admitted
to hospital, "comparatively few have been persons with a
settled residence." The sources of infection in these cases,
except in a few instances where more than one person of the
same family or household was attacked, had not been discovered,
and the disease had, "no doubt, been contracted in a
chance way by such persons coming in contact with infected
persons, in the streets or where-not." In the same report it
was pointed out "that the disease had as yet got but little
hold upon the settled population of London. "It had" been
imported by tramps and others from the provinces; and such
importation is continuing, is likely to continue, and cannot be
prevented. The class," it was added, " which so far has been
almost entirely affected, is the vagrant class, and the disease is
being spread by persons of this class coming in contact with
one another in the Casual Wards of Workhouses and other
places. In most of the cases the disease appears to have been
contracted in one of the Casual Wards, and many have been
sent (to hospital) from Casual Wards and Workhouse
Infirmaries Owing to the migratory habits of
these persons it is difficult to say in which particular Casual
Ward the disease was contracted Every Casual
Ward in London is acting as a source of infection." The
Chairman of the Asylums Board, Sir Edwin H. Galsworthy,
caused the above extract from the report of the Medical
Superintendent of the Hospital Ships, to be sent to the
several Metropolitan Medical Officers of Health, with a statement,
that "the adoption of some measures for preventing the
further spread of the disease in London is of vital importance";
and it was suggested that "one most effective means to
that end would be'a systematic medical inspection of Casual
Wards, Shelters, Common Lodging Houses, &c., through the
agency of which, it would appear, there is risk of the disease
being widely disseminated a conclusion which is justified by
the observation of the Medical Superintendent of the Hospital