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Dr. Gayton has further informed the Registrar General that since
the hospital was opened, more than seven years ago, 367 nurses and
others have been engaged in the work of the hospital, and, with the
solitary accidental exception mentioned, re-vaccination has been an
indispensable condition of employment, unless the applicant had had
Small-pox or had already been re-vaccinated. The result has been
that not one of these has contracted Small-pox while there employed:
I am reluctantly compelled to state, that it is my firm conviction
that the present plan of carrying out the provisions of the Vaccination
Act is inefficient. All Vaccination, by whomsoever performed, should
be certified, after inspection, by a public vaccinator only, and his instructions
should be to grant two classes of certificates. Those not
having sufficiently good marks, to be placed in the first class,
should only be granted a provisional certificate with the understanding
that they should be submitted to a second vaccination in a
year or two, as the protective influence of an imperfect vaccination
rapidly wears away, and the operation must be repeated to insure
immunity from Small Pox.
As to the second question, there is no doubt that the isolation
of patients affected with the disease under consideration is most
imperfect. In the existing state of the law, people are practically
allowed to exercise their own option as to removal to the Small Pox
Hospitals; the only cases in which the Sanitary Authorities can
interfere are where there arc more than persons of one family inhabiting
a room, or where the person subject to the disease is improperly
lodged. Removal should be made compulsory by law in all cases of
infectious disease, when the means of isolating the affected person
are not satisfactory to the Medical Officer of Health ; and in disputed
cases proceedings might be taken at the Police Court before a
Magistrate, whose order for immediate removal to a hospital should
be carried out without delay. Vigorous proceedings of this kind
would soon cut short an epidemic, and many valuable lives would be
saved.
While considering the manner of dealing with infectious diseases,
I may as well refer to the whole subject of Hospital accommodation
for such cases, and I am happy to say that there is some probability
of a speedy and satisfactory settlement of this most important matter.
As before mentioned, the powers of the Sanitary authorities are