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19
As I went so fully into the details of the outbreak of small pox in
my last Report, especially as regards the influence of the Homerton
Small Pox Hospital in the causation of this disease, I need not
discuss again this last part of the subject, except to say that the
events of the past year have fully confirmed the opinion previously
expressed. I desire, however, to say that as regards Small Pox
Hospitals, I believe they are almost certain to exert a more or
less prejudicial influence on the health of the inhabitants of their
neighbourhood, if more than 100 patients are admitted, and
that, therefore, more than that number should not be treated on
one site, except in a great emergency, and that, under any
circumstances whatever, the number should be absolutely limited
to 150. Also there should not be more than 25 patients to an
acre, with a space of at least 150 feet between the wards and the
surrounding wall. That all the offices and the dwelling of the
medical officers and others, should be outside the walls; that if
fever and small pox be treated on one site, there should be two
entrances, and that there shoidd be a gateway into which the
ambulances could be driven whilst waiting for admission. I would
also express my opinion that the infection of this disease can be
earned by the air as well as by articles of clothing; but when
the number of patients treated in a hospital is small, judging
from what has happened in this District, I believe that infection
by air is comparatively rare. When a large number (above 140)
were in the Homerton Hospital, the risk was apparently increased
even in a greater proportion than the number of patients. The
repeated outbreaks in Templar Road, Clifden Road, Holmbrook
Street and Brooksby's Walk, and the time of their occurrence,
can only be explained on this supposition.
The endemic of small pox in the vicinity of Wellington Street,
Shacklewell, was very severe, although it lasted less than 2 months.
The outbreak occurred first in the person of a child, who was attended
by a private practitioner, at No. 6, Wellington Street, in December,
1880, convalescence having taken place about the 20th. There
were two families in the house. The disease broke out suddenly