Observations of the Medical Officer of Health [E.W. Hope] upon the report of Dr. R.J. Reece to the Local Government Board on smallpox and smallpox hospitals at Liverpool, 1902-3.

  • Hope, E. W. (Edward William), 1855-1950.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Observations of the Medical Officer of Health [E.W. Hope] upon the report of Dr. R.J. Reece to the Local Government Board on smallpox and smallpox hospitals at Liverpool, 1902-3. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

    14/48 (page 12)
    VJ '■ bi oadly speaking —as Dr. Ueece expresses it—with his coiicliision- tliat “the dwellings nearei' to hospital have sustained a far heavier incidence of small]iox than tliose further away.” The case of Priory Poad, like that of Fazakerley, negatives the conclusion absolutely, notwithstandiug any jilea for indulgence for inaccuracies set up by the saving phrase, “ broadly speaking. The very laige number of cases in which the infection was clearly traced, furnishes a sufficient explanation for the incidence of smallpox within the othei' zones of this Hospital, and there is therefore no occasion to theorise when the infection can be shown to have arisen in other ways. Parkhill Hospital. Prior to the use on January 12th, 190J, of the Parkhill Hospital for the treatment of smallpox, the disease had repeatedly been present in its vicinity, on one occasion within fifty yards of the boundary walls; in January, 1902, a house within the three-quarter mile zone was invaded by smallpox; in February, 1902, one house was invaded within the quarter mile zone, and two houses within the half to three-quarter mile zone; in March, 1902, a house within the half to three-quarter mile zone was invaded, and one between the three-quarter and mile zone; in November, 1902, one house in the three-quarter to mile zone was invaded; in January, 1903, three houses were invaded within the half and three-quartei- mile zone ; and one house between the thi-ee-quarter and mile zone. There were therefoie twelve separate and distinct invasions of houses within the alleged zone of influence before the hospital received its first case of smallpox on January 12th, 1903. Figures are given in Dr. Peece’s Peport indicating an enormously greater incidence in house invasion within the quarter-mile radius of this hospital than at Priory Poad, although there are only 86 more houses in it than in the Priory Poad Hospital quarter-mile area, the number of inhabitants being about double. The house invasion in the I’arkhill Hospital area is stated to be 526 per 10,000, as against 85 foi' the rest of the City, excluding the hospital areas. Five hundred and twenty-six is a very large figure to use, and it is a relief to know that it means tiie invasion of only nine houses. During the six months of the use of the Parkhill Hospital for smallpox patients nine houses were invaded within the quarter mile zone of the hospital. What probability is there of these nine invasions having an origin analogous in character to the twelve, which occurred in the vicinity before this hospital was used for smallpox at all? If the origin of any of them can be proved to have no more connection with the hospital than the Netherfield cases had with Netherfield Poad Hospital (see comparsion, page 15), the table ceases to support the theories drawn from it. Four of the nine patients had, it was known, been exposed to infection elsewhere. In the same way, proceeding outwards from the quarter-mile zone to the wider ones, there is a very long series of instances of infection from person to pei'son, a few of which, illustrative of the rest, are given in the appendix, those without the zones and those within the zones receiving or imparting infection in the same way.