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.

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    3. THE ALLEGED INFLUENCE OF THE HOSPITALS. It is, however, with the third matter that the great bulk of Dr. Keece’s Kepoil deals, and the importance of this section calls for more detailed examination, since if Dr. fleece’s assertions are well founded the Hospital for Smallpox, erected upon a site carefully selected for the purpose, and approved of by the Local Government Board after full and complete inquiries by the Board’s experienced Inspectoi's, must be closed as a ])ublic dangei'. The Cor])oratiou of Liverpool and the Hospitals Committee, as well as the Local Government Board, are therefore seriously concerned to know whether the conclusion come to by Dr. Heece— viz., “ I am compelled to consider that the influence of these hospitals has been responsible in mateiial degree for the considerable and sustained prevalence of smallpox in Liverpool in 1902-3 ”—is justified by the facts available foi- his consideration, or whether the su])pression and disregard of these facts (for no reference has been made to them in his Report) lunder his conclusions valueless. It is necessary for the infomiatiou of the Committee to make some preliminary observations upon the general question of small- pox diffusion by air, and the evidence upon which it is based. It was in 1882 that some valuable Reports were placed before the Local Government Board by the late Sir Richard Thoiaie Thorne, and by Mi\ W. H. Powei“, the foianer dealing with Fever Hospitals, the latter with Smallpox Hospitals; both Reports have exeited an exceedingly beneficial influence in this country, in regard to hospital construction, location, and administration. In regard to the question now under consideration, special interest attaches to the Repoi’t of Mr. W. H. Power, the present Medical Adviser of the Imcal Government Board, who, as the result of careful and prolonged investigation into the circumstances attending the use of the Fulham Hospital for Smallpox, was led to the conclusion that under certain conditions, smallpox had been spread from the hospital by means which could not be ascribed to any of the ordinary channels of infection, but which pointed, as his evidence showed, to atmospheric diffusion, or aerial convection. The care and impartiality in examining and weighing evidence, and the conciseness and lucidity of his Report, rendered the conclusions very convincing, and the inferences received a wide acceptance. But Mr. I^ower was careful to point out that “ Smallpox is a disease infectious beyond all others of its class. Not only does it spread with greater facility than, foi* instance, scarlatina or typhus, but the measures of isolation and other precautions against dissemination which suffice with those diseases are, as regards smallpox, altogether futile. Not only is it unsafe to place smallpox in hospitals side by side with othei- infectious diseases, but it is also unsafe to deal with linen, blankets, bedding, Ac., of smallpox })atients in any but a separate laundry. Further, smallpox can without doubt be readily ti’ansmitted to others by pei-sons who have been in close relation with the disease, though they themselves may not suffer from it; and similarly, smallpox may be ti-ansmitted with comparative readiness in clothing, parcels, &c., from an infected to a previously uninfected dwelling ” “ Cases of smallpox, themselves so little serious as to be mistaken for ‘ chicken pox,’ have in our ordinary experience the power of ])ioducing in unprotected persons severe attacks of the disease.