Year by year greater use was made of the Board’s hospitals, and at times there was not sufficient room in the Metropolitan Asylums hospitals to receive all the cases. In 1892 the total number of patients received amounted to over 13,000, there being at one time 4,389 patients suffering from all classes of fever or diphtheria receiving treatment in the hospitals, whilst in 1893 the admissions amounted to 20,316.
By 1895 the Board had eight fever hospitals, including diphtheria, with 3,384 beds; three ships for smallpox cases with 300 beds; and a large hospital for convalescents with 1,200 beds. By 1898 the accommodation had reached the large total of about 6,000.
The Chairman of the Metropolitan Asylums Board, reviewing in 1897 the thirty years’ work of the Board, said:—
“Whilst, during the first twenty years of the Board’s experience, London was again and again visited with epidemics of smallpox, during the past seven years it has, thanks to the action of the managers in having removed to and isolated at Long Reach all cases of the disease, been practically non-existent as a health disturbing factor.
“The percentage mortality of smallpox cases treated by the Board decreased from 20·81 in 1871 to 4·0 in 1896, and the annual mortality from 2·42 to practically zero.”
The rate of death from diphtheria also showed a continuous fall, and this fall had been coincident with the introduction and increasing use of the anti-toxic serum treatment of the disease.
A valuable criticism on the existing machinery for the sanitary government of London was given in a report of the Metropolitan Asylums Board Statistical Committee in June, 1892:—
“Although London possesses an ambulance service and a system of hospitals admittedly unrivalled, yet it has no central authority charged with the duties of tracing out an outbreak of this infectious disease (smallpox), and of taking concerted action towards stamping it out by measures of disinfection and vaccination and re-vaccination.
“These matters still remain in the hands partly of the 41 local sanitary authorities, partly of the Local Government Board, and partly of the London County Council.