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Ships that "cases come under (his) notice which have passed
through such institutions without the disease
being recognized." It would have been difficult to obtain the
desired "systematic medical inspection," excepting in the case
of Casual Wards; but I thought it might be possible to induce
the Superintendents of Shelters, and the keepers of Common
Lodging Houses, to report to the Poor Law Authorities the
occurrence of cases of apparent illness, especially if accompanied
by an eruption, among the inmates of such places; and
in view of the facts stated in the above-mentioned communication
from the Asylums Board, I felt it to be my duty to put
myself at once in communication with the Keepers of
Common Lodging Houses, to each of whom I addressed a
letter as follows:—
"Small-pox.—Sir.—This disease is spreading in London. So far, most of
the sufferers have been poor persons who usually sleep in Casual Wards,
Shelters, and Common Lodging Houses, and tramp about Town and
Country by day. I ask your help to prevent the further spread of the
disease; by careful inspection, night and morning, of the people who
sleep at your house. Small-pox commonly begins with pain in the head
and back, and sickness. But one or other of these signs may be absent,
as all cases are not quite alike. Should any Lodger complain of illness
of this character, I beg you to obtain a Medical Order from the Relieving
Officer before such person leaves your house, and especially if there is
any rash. The rash of Small-pox comes out on the third day of illness,
as small hard pimples, which soon get bigger and soften, and then they
contain fluid and are like little blisters. In your own interest, as well as
in the interests of Public Health, I hope you will give this matter your
serious consideration."
I forwarded a copy of the above communication to the
Clerk to the Guardians, and to the Police Authorities who have
the supervision of the Common Lodging Houses. The
Guardians made an arrangement with their Medical Officer
in charge of the Mary Place Workhouse, "to attend daily at
the Casual Ward, and subject each casual to a medical
inspection before discharge and the police were" directed to
assist, as far as practicable, in impressing on the Keepers of