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in the number of cases occuring in the two parishes. If there was
a Fever Hospital in or near the parish of Fulham many persons
would immediately conclude that it was most undoubted evidence
that the excess in the number of cases in the one parish as compared
with the other, was due to the disease spreading- from the
hospital, but, clearly there must be some other cause in the
absence of a Fever Hospital in or near the parish. We are
led to the conclusion in the absence of any other evidence
that more imperfect isolation of the infected is the cause
of the difference in the number of cases of Scarlet Fever
occurring- in the two parishes. May we not reasonably ask the
question. " Is there not a common cause for the greater number
of cases of all the zymotic diseases in the parish of Fulham, as
compared with Hammersmith ?" It should be noticed that from
all the zymotic diseases, Small-pox excepted, there were 165
deaths last year in the parish of Hammersmith, and 172 in the
parish of Fulham. When we take into consideration the fact
that there are about 25,000 more inhabitants in the parish of
Hammersmith than in the parish of Fulham, this difference in the
number of cases is most important evidence in favour of the hospital
not being altogether the cause of the greater prevalence of
Small-pox in the parish of Fulham. I am somewhat surprised that
it was generally understood from my report last year that I was in
favour of the Asylum Hospital in Fulham, being used for the reception
of Small-pox cases. Such was not my wish. I simply
laid before you the evidence that I had been able to obtain, my
opinion was and is against the theory that the disease is propagated
by the virus being carried long distances through the air,
but yet I do not attempt to assert that there is any conclusive
evidence in medical science that such a means of propagation is
impossible. It appears to me that in the absence of any clear
evidence, that the disease has spread from the hospital. It is a
pity that anyone should alarm the inhabitants, as there can be no
doubt that injury is done to the parish by the report, be it well
founded or not. There can be no doubt that the presence of a
iSmall-pox Hospital in a District is a cause to some extent of the
prevalance of the disease in the locality, i.e., by visitors from the
iinfected locality from which the patients have been brought; also
:to some extent by direct contagion through officials in the
•removal of cases. It is to be regretted that some energy
iis not expended in assisting your officers in the removal of
ithose attacked, as there can be no earthly doubt that a very
; large proportion of the cases would never occur if proper isolation
i in every case was adopted. It is a great question whether the
treatment of a large number of sick persons in any large hospital
iis desirable, even when they are suffering from non-infectious
^complaints. More particularly doubtful is the utility of