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was not reported till 5 days after the patient was attacked, consequently
three other persons contracted the disease. In the
case at Kenneth Road the patient was found to be suffering
from "variola hemorrhagica," the worst form of smallpox,
an always fatal complaint. He had only been married 10
days, so he must have caught the disease about 4 days before
his marriage. I saw the case at night, and pronounced it hopeless.
I ordered his immediate removal to the hospital, where he
died the following morning. The whole surface of his skin was
was covered with versicles full of blood, besides which blood was
flowing from his ears, eyes, nose and mouth.
Last year over £ 100 was directly saved in the maintenance of
the smallpox patients through their removal to the Asylum
Hospitals, instead of to Highgate. An arrangement was entered
into with the Fulham Board of Guardians in the year 1877 that
all cases of infectious disease should be removed to the Metropolitan
Asylum Hospitals, and that your Board should refund to
the Board of Guardians the amount charged upon them by the
Asylum Board for the maintenance of the patients. A very
large proportion of the patients removed by your Board were
paupers, consequently it seems rather absurd that your Board
should do all the work and refund to the Board of Guardians
the expenses for the maintenance of paupers; still, so many
have been the difficulties in dealing with the question of the
Guardians removing cases, that on the whole it seems to be the
only way of meeting the case, having due regard to the public
safety. In the parish of Kensington there has not been the
difficulty experienced that has been met with in this district. In
that parish the Guardians remove all the cases and make no
charge to the Sanitary Authorities. In accordance with the
provisions of the Poor Law Amendment Act, 1879, application
has been made to the Local Authorities of London by the
Metropolitan Asylum Board, asking them as to what terms of
contract they would be willing to enter upon with the view of
sending non-pauper cases of infectious disease into the Metropolitan
Asylum Hospitals. No definite terms of contract have, as
yet, been arranged, but as a matter of fact most, if not all, of
the Sanitary Authorities have been sending patients into the
Asylum Hospitals.
TABLE.
The following table shows the number of cases of smallpox
that were reported in each of the parishes during the 12 months
of the year 1880; also the number of cases that were properly
isolated at a hospital and those that were treated at home;—