View report page

7
proportion of 224 to 133 per 100,000 population, but before the
end of the epidemic the difference will most probably not be so
great.
There is one question of considerable moment which
naturally arises out of those statistics, viz.:—to what extent, if
any, the presence of the Small-pox Hospital in our midst has
acted as a cause for the severity of the outbreak? To this I would
reply that in 1871 there was evidence to show that the population,
near the hospital, suffered more than in other parts of the
district, and the same obtained in 1876-78; but the inhabitants
of the same streets were not attacked in the same ratio in the
two epidemics, as those who were living in some of the adjacent
streets suffered more severely in 1877-78 than in 1871-2. Again
the disease first broke out in the district amongst persons who were
in communication with, or in attendance on those who had contracted
the disease outside the district, and it is certain that
isolation of the sick very materially prevented the spreading of
the disease. There is also another difficulty, viz.:—that we are
not informed of every case as we should be if the registration of
infectious diseases were made compulsory, so that our returns are
very imperfect. There is another matter of considerable interest,
viz.:—whether or not we should have been in a better position
with a hospital for non-pauper patients. My opinion is that we
should not as there would have been in many cases a question as
to which hospital patients should be sent, and valuable time
would consequently have been lost. Further, whenever there is
a choice of hospitals, application would be made to the officers
having the power to send patients to the particular hospital, which
the patients or their friends preferred, without regard to the claim
they had on one rather than on the other. Besides this the cost
and trouble would have been very much greater, without any
corresponding advantage, for so far as 1 know, everyone was
removed to a hospital who would go there. A few were taken
to the Islington hospital at the expense of the patients' friends,
and in no case was it necessary for me to send a case at the cost