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patients have been moved into and out of the hospital—as
many as 224 having been brought in and taken away in one
week in May, very few of whom were counted as patients
because they did not sleep there—I cannot say how far this
incessant oarrying about of small-pox patients in the district
assisted in infecting the neighbourhood, but I believe it was
decidedly injurious. As a contrast, I may mention that in 1871
there was a small-pox hospital at Clapton, in which there were
not, to the best of my knowledge, so many as 30 patients at any
one time, and the moving of patients to and fro was comparatively
rare. The disease spread to two houses only, and those
were next the hospital recreation ground. The back gardens
of a row of houses behind the hospital were within 30 feet of
the hospital, but the disease did not spread to any of the
inmates. There is, however, a difficulty arising from the more
or less perfeot vaccination of those exposed to small-pox
infection, and therefore I cannot say if the disease would have
spread if the inhabitants of these houses had been susceptible to
the disease. There was not any house near the front or sides of
this hospital, except the two just mentioned.
Before concluding these remarks, I desire to express my
opinion that the number of patients who may be safely
treated in a hospital during non-epidemic periods should not
be received and kept there during an epidemic. I am also
of opinion that all the evidence I have read shows that every
one of the metropolitan small-pox hospitals has proved injurious
to the public health of the neighbourhood in which it is
placed; but I believe that it is possible to treat patients
in small numbers in hospitals in London without injurious
results. The wards, in my opinion, should be small; the
traffic of ambulances, visitors, tradespeople, and others as
restricted as possible; the open space surrounding the wards and
recreation ground as large as can be obtained; and that means
should be taken to prevent small solid particles being blown