Memorandum by Dr. R.J. Reece on considerations adduced by Dr. Hope in reference to a report by Dr. Reece on smallpox and smallpox hospitals at Liverpool, 1902-3 / Richard J. Reece.

  • Great Britain. Local Government Board.
Date:
[1905]
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Licence: In copyright

Credit: Memorandum by Dr. R.J. Reece on considerations adduced by Dr. Hope in reference to a report by Dr. Reece on smallpox and smallpox hospitals at Liverpool, 1902-3 / Richard J. Reece. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    !ul 10JUN.1929 Inter-departmental. I i ' Cji.u*! <;,v fci. f'l5S° Memorandum by Dr. R. J. Reece on considerations adduced by Dr. Hope in reference to a Report by Dr. Reece on Smallpox and Smallpox Hospitals at Liverpool, 1902-3. At the desire of the Board I submit comments on the observations of the Medical Officer of Health upon my report to the Local Government Board on Smallpox and Smallpox Hospitals at Liverpool, 1902-3. Dr. Hope, in his report to the Liverpool Corporation on “ The recent outbreak of smallpox in Liverpool,” dated 31st December, 1903, stated (p. 28) : “ Until within recent years there was an impression that a smallpox hospital, “ however well conducted, must necessarily be a source of infection to the district in “ which it is situated, owing to what is known as aerial convection, i.e., conveyance of “ infection for prolonged distances through the atmosphere. It is important, therefore, “ that the experience of the Liverpool hospitals in this respect should be borne in “ mind, because it shows that in strictly disciplined institutions, placed as these hospitals “ are, no danger arises from this source.” And in February, 1904, Dr. Hope tendered evidence in a Court of Law to the same effect. Thus, Dr. Hope had already, before my inquiries were begun, denied the existence of spread of smallpox round Liverpool hospitals due to aerial con- vection, and had also stated that the administration of the hospitals had been successful in preventing the spread of the disease from them by other means. An opinion has sometimes been expressed by those engaged in public health work, that the Medical Department of the Local Government Board should investigate the circumstances of a case in which it is believed that a hospital situated in a populous district and used for the reception of acute smallpox patients during a considerable epidemic, has exerted no adverse influence on the population in its neighbourhood. The Liverpool epidemic of 1902-3, in view of the statement above quoted, seemed to offer such a case ; but the first requisite was knowledge of the facts. It was into the facts that I was instructed to inquire, and in particular whether there had been any excess of incidence, as regards smallpox invasion, upon houses situated around the several Liverpool hospitals which had been used for smallpox, during the periods in which those hospitals received smallpox patients. The result of my inquiry is set forth in my report. By the publication of the facts obtained by my inquiry, Dr. Hope appears to have been placed in the position of having to accept my conclusions as to the existence of “ hospital influence ” in Liverpool unfavourable to the health of that City, and acknow- ledge that he had been hasty in 1903, or of attempting to explain away the facts established by my inquiry, so as to justify in some measure statements in his report of December, 1903. It is necessary to point out that he had not worked out prior to the publication of that report the data which were absolutely essential before any pronouncement could properly be made on the question of hospital influence. I have now supplied these data, and Dr. Hope cannot find fault with my facts, for my report is little else than a collection and an ordering of facts which were supplied me by Liverpool officials. 100 Wt 12579 9/05 D & S (E) 19 22439