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can be easily ventilated, made warm in winter, and are cool in
summer. All that is wanted is plenty of fresh air, suitable
nourishing food, perhaps wine, perfect cleanliness, careful watching,
an experienced medical man on the spot.
The Sanitary Committee have taken some trouble to secure
all needful comforts in connexion with the removal of the sick.
Several suggestions in accordance with my report on improvements
in the fever ambulance have been adopted; an air bed
and pillow, a hot water bottle, a ' step for entering, better
ventilation, a speaking tube, &c., a stove for warming the shed
in which the carriage is kept were suggested. The mode of
removal of Fever and Small Pox patients to a hospital is a
matter of some tact, delicacy, and judgment; the erection of
large hospitals at a distance of three to six miles away from a
patient's home was not judicious; many cases of death soon
after the removal have occurred; while delay in getting orders,
and going through unnecessary formality is highly objectionable.
The Metropolitan Asylum Hospital Authorities ought to have
been charged with the duty of fetching as well as of returning
home patients after they are cured.
After so much has been said about Vaccination I may be spared
repeating, except in a few words, what is my own as well as the
general experience of medical and other observers, (a) That if
vaccinated, the vaccinated cases have generally escaped the
worst forms of Small Pox and are less fatal. (b) That the
un-vaccinated, both adults and children have had severe attacks,
(c) That there are many imperfectly vaccinated persons about,
and a large number of the children in schools are not absolutely
protected by old vaccination. (d) That re-vaccination has been
considered desirable in all doubtful cases, and during the epidemic.
(e) That few instances of Small Pox have been known to occur
after re-vaccination, or after a mild attack of Small Pox.
A house to house visitation, in order to seek out un-vaccinated
persons has not been recommended in the Parish. Public opinion
aided by a general desire for re-vaccination has sufficiently met
the requirements of the Vaccination laws; except in some instances
where one or two members of the anti Vaccination League, who
live in this Parish, have frightened the timid and ignorant by
their senseless outcry and publication of pernicious doctrines.
The Board of Guardians are the authority for carrying out
Vaccination, and they entrusted me with the inspection and
prosecution of defaulters under the provisions of the Act of 1867.
Since 1868 more than 3000 inspections have been made by me
and my Assistant. A monthly list of defaulters is taken out