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15
were necessary for the protection of the public health. In
my report of March 24th, I pointed out the injury arising
from the gates being kept shut and children crowding round
the ambulance whilst waiting, which had not been altered
in December, 1880, when I again reported on the subject.
There were comparatively few cases between March and
November, which induced me to wait in the hope that as
this District had suffered from small pox in 1876-78, the
disease would not again become rife before October, 1881, or
perhaps later. This speedy recurrence of the disease, contrary
to what happened before 1871, is I think another proof
that some cause of small pox has been newly introduced
into this District.
There are two points of considerable importance for
consideration, viz., (1), to what extent the infection of small
pox can be carned by the air; and (2) how much of the
disease is attributable to direct infection by means of ambulances,
by visitors and tradespeople going to the Hospital,
and by transmission of the sick themselves. As regards the
first point, the Infirmary of the City of London Union is
placed within 90 feet of the Fever Hospital, which has been
used for small pox patients, but no cases of the disease
occurred there. The almost complete immunity of the
inhabitants in Walsingham Eoad, (only one case having
occurred there, and then not in a house adjacent to the
hospital,) when the Small Pox Hospital was placed within
34 feet of the back gardens, shows that air flowing from
a small hospital is scarcely likely to carry the infection
beyond 40 or 50 feet, so that we may fairly assume that if a
hospital of this kind and its outbuildings were surrounded
by a belt of land of at least 100 feet, there would not be
much probability of persons outside becoming infected
through the air. On the other hand, the frequency with
which the inhabitants of certain houses in Brooksby's Walk
and in the Grove, suffered, shows that it is not safe to have a
large hospital, laundry or recreation ground for this disease,