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8
gation on him, be similarly required by law to furnish the sick
person, or those in charge of him, with a certificate of the nature of
the disease to be by them communicated to the Medical Officer of
Health. On every certificate so commnnicated a small fee should
be paid to the Medical man who signed it.
"If the Medical officer after receiving such certificate is satisfied
that the patient can and will be properly isolated, and requisite
means of disinfection adopted, the matter will proceed no further.
"If he is not so satisfied, and if the sick person is not too ill
to be removed he will notify the case to the Metropolitan Asylums'
Board, who will thereupon be at once and entirely charged with the
patient till his complete recovery, and in particular will be empowered
to remove him at once to one of their Hospitals. So far
no distinction should be made between paupers and non-paupers
who cannot be isolated. But within the Hospital those who are
desirous of being placed in separate wards should be allowed such
accommodation on paying for it. In case of ordinary accommodation,
it appears to us a question whether payment should be
claimed even from those who can make payment without difficulty.
"If the sick person cannot be removed or isolated by those
about him, the Medical officer will be bound to take all necessary
steps for his isolation, and generally for the protection of the
neighbourhood, with power to clear the house of its inmates. In
all cases he will be bound to disinfect the house, and in the case of
houses invaded by Smallpox should be empowered to require the
re-vaccination of all occupants who are not otherwise protected."
These recommendations appear to me of an eminently practical
character, and calculated to check to an extent hitherto unknown
in the Metropolis the spread of infectious disease.