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62
The above table is taken from the report of the Medical Superintendent
of the hospital. In my table of the cases removed from
the Fulham district, it will be observed that the total number of
cases is 139. I have not entered the cases which were removed
from this district, and afterwards found not to be Small-Pox.
None of these 5 cases were seen by myself, but were removed on
the certificates of medical practitioners in the district. Strict instructions
are given to the Inspector not to remove any cases of
Small-pox, unless with a certificate signed by a medical practitioner,
as in case of mistake in the diagnosis, an action for damages might
be brought against the practitioner who signed the certificate.
This precaution is most necessary,as incases of mistaken diagnosis
it would save your Hoard from any liability. It will be seen from
the above table that the greatest number of cases was received
from this district, then comes St. Mary's, Kensington, and then St.
Luke's, Chelsea. These facts appear to indicate that the presence
of the hospital has something to do with the number of cases
occurring in these districts. It is a fact that the three districts
that are in the closest proximity to the hospital sent in the largest
number of cases, but of course, this fact by itself, proves nothing,
as there may have been a larger number of cases in some
of the other districts, and that some of those were either not removed,
or were removed to one of the other Small-pox Hospitals.
Besides we might expect that a greater percentage of cases
which occurred would be removed from those districts to the
hospital near which they were situated, than to hospitals which
were a greater distance off. The convenience of having a
hospital near at hand is a great assistance in the removal
of cases, as there is a large number of patients which could
be removed to a hospital half a mile off, but which could not be
taken a long distance. By reference to my last Annual report, it
will be seen that I could obtain on the one hand no direct evidence
that disease had spread from the hospital either through direct
contagion, or through the air becoming infected, but that on the
other hand the existance of a large amount of disease, more
particularly in the parish of Fulham, could be accounted for,
owing to a very large number of the cases being concealed and
treated at home without sufficient isolation. I have to record the
same experience last year. Here it should also be noticed that
Small-pox was not the only infectious disease that was more
prevalent in the parish of Fulham, than in the parish of Hammersmith
last year. There was a greater number of other
zymotic diseases in the former parish than in the latter. Thus,
for instance, the number of deaths from Scarlet Fever in the
parish of Fulham was 55, which equals about l,loo persons
attacked, while there were only 37 in the parish of Hammersmith,
which equals about 740 cases. This is a great difference