president's address — SECTION I. 191 



important matter in relation to the outgoing air from a smallpox 

 hospital. The omission could be easily remedied, as means are at 

 hand for super-heating steam. 



At Glasgow provision is made, not only for the patients, but in 

 some cases for their families in reception or observation wards con- 

 nected witli the hospital establishments. Otiservation wards for 

 doubtful cases are very useful adjuncts to all hospitals for infectious 

 diseases. The proper construction of ambulances tor the transport 

 of infectious cases is very important, but still more important is the 

 proper regulation of their work and service. 



Hospital treatment, though primarily intended for the cure of 

 disease, is certainly one of the most effectual means of preventing 

 its spread in highly infectious cases, such as those of scarlet fever, 

 as in the removing a patient the source of inl'ection is removed from 

 a family. I'robably the diminished death rate from scarlet fever of 

 recent years in Great Britain is due to hospital isolation and treat- 

 ment, as diminished death rate from smallpox is due to vaccination, 

 diminished death rate from typhoid fever to sewerage, and 

 dimininished death rate from diarrhoea to improved water supply. 



With respect to hospital accommodation for infectious diseases 

 that should be made in large cities, it is probable that a permanent 

 provision of one bed for each 1,000 or 1,200 of the population 

 would be sufficient. The present provision in London is about one 

 bed for each 1,400. In Aberdeen, Birmingham, Edinburgh, and 

 Glasgow it varies from one for 1,000 to one for 1,200; while in 

 Cardiff it is only one for 2,500, and in Dundee one for each 4,000 

 of the population. 



In small communities I should advise that provision be made of 

 a proper site, with such preparations as would enable the Health 

 Board to at once isolate the more serious infectious cases when 

 necessity arose. At Launceston we have secured twenty acres of 

 suitable and easily accessible land about three miles from the centre 

 of the city. The site is high and well wooded, and has a sandy 

 soil over gravel. An acre in the middle of it is surrounded with a 

 high fence, Avithin which are arranged concreted and asphalted 

 platforms to receive hospital huts or tents ; and drains are laid and 

 water supplied. Hospital huts could be put up at a few hours' 

 notice, and tents immediately. I believe this to be the most 

 economical way for such a community to make jireparations 

 against, say, a visitation of smallpox, as no staff is required until 

 the emergency arises. Beyond this, provision of a proper ambu- 

 lance should be made and its service organised. 



The proper disinfection of houses in which cases of infectious 

 disease have occurred is a matter that cannot safely be left to 

 private enterprise and responsibility. It is one that can be more 

 efficiently as well as more economically done by a staff of trained 

 workmen, who can, moreover, do the work with safety to them- 

 selves. 



