London's Pulse: Medical Officer of Health reports 1848-1972

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Whitechapel 1876

[Report of the Medical Officer of Health for Whitechapel]

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A condition of the highest importance for the usefulness of any such accommodation
is that the accommodation SHALL BE READY BEFOREHAND.
It ia not proposed to discuss in detail, in this memorandum, the principles on
which permanent hospitals for infectious diseases should be built; but it may be
noted that, in order to the practical success of any such hospital, the following
conditions have particularly to be studied:—
Accessibility of situation, so that the sick may not be exhausted by long journeys;
wholesomeness of situation; and, as far as consists with these conditions, an open,
uncrowded neighbourhood.
Adequate ward space for each patient, approaching as nearly as circumstances
allow to 2,000 cubic feet, with a floor space of not less than 144 square feet.
Thoroughly good provision for ward ventilation (i.e., for sufficient unceasing
entrance of pure air and of exit of ward air), with arrangements also for immediate
change of air in the whole ward, when necessary:
Perfect security against the possibility of any foul air (as from privies or' sinks)
entering any ward :
Means of warming each ward in winter to a temperature of 60° Fahrenheit, and
of keeping it cool in summer:
Safe means (safe both for the hospital and for the neighbourhood) for disposing
of exeremental matters and of slops, and for cleansing and disinfecting infected
linen and bedding:
Facilities for obtaining, in the use of the hospital, the very strictest cleanliness of
every part.
For the conveyance of patients who are sick with infectious disease special
carriages, which are known by the name of 'Ambulances,' are necessary. Such
carriages may be provided by the Sanitary Authorities under section 123 of the
Public Health Act. The following points have to be attended to in the provision and
use of such carriages:—
1.—If the ambulance be intended only for journeys of not more than a mile, it
may be made so as to be carried between two people; or it may be on
wheels to be drawn by the hand. If the distance be above a mile, the
ambulance should be drawn by a horse. Every ambulance on wheels
should have easy carriage springs.
2.—In the construction of an ambulance special regard should be had to the fact
that after each use it has to be cleansed and disinfected. The entire
interior, and the bed frame and bed, should be of material that can be
3.—The ambulance should be such that the patient can lie full length in it, and
the bed-frame and the bed should be moveable, so that the patient can be
arranged upon the bed before being taken out of the house.
4.—With an ambulance there should always be a person in charge of the patient;
and a horse ambulance should have a seat for such person inside the
5.—After every use of an ambulance for infectious disease it should be cleansed
and disinfected to the satisfaction of a Medical Officer.
6.—Both-in populous districts, and in districts which are of very wide area, it
may often happen that more than one ambulance will be wanted at one
time ; and, in any district, if more than one infectious disease is prevailing,
there will be an evident sanitary advantage in having more than one
ambulance for use."
The number of births registered in this District during the year has
been 2754, and the deaths 2348, including those of non-residents in the
London Hospital (511). In the preceding year the births were 2660, and
the deaths 2470, including the deaths of 465 non-residents.
The deaths in the Workhouse have been 335, against 351 for the
previous year; and the deaths in the London Hospital 716, against 710.
The population of the District, at the taking of the last census, was
76,573; which is 2397 less than when the census was taken in 1861.

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