Patients in the natural way are received every day, if there is room for them; and to prevent the danger and expence of a disappointment, enquiry should be first made. Patients for Inoculation are also received every day at Pancras before nine in the morning.
Strangers are forbid to visit the patients.
Cloaths are provided for the patients, while their own cloaths are freed from infection before their discharge.
As the first outline of every attempt towards a new institution has for the most part been imperfect, it is not to be wondered at if the plan and regulations of these Hospitals should admit of improvements; and the following remarks will perhaps point out some regulations that deserve attention.
It is now near thirty years since the first establishment of this charity; at which time it was the received opinion that a strict regimen ought to be observed, and a course of medicine complied with, by way of preparing the most healthy previous to their Inoculation. It was also believed, that there was some risque of taking the natural infection injuriously at the time of being inoculated, and danger of accumulation by residing with others who had the disease; and the inoculators of that time who made use of infected thread and lint, sometimes failed infecting on the first trial, and in such case the patient would probably catch the natural distemper by cohabiting with the sick.
These opinions, it is presumed, joined with the design of admitting patients in the natural Small Pox, determined the first Governors to have two Hospitals; one, to contain all such who were actually undergoing the disease in either way, and in a state to infect others: the other to be appropriated to such only who were under preparation, or having been inoculated had as yet no appearance of the usual eruptive symptoms, and were not in a condition to infect one another. But these opinions have not been verified by experience; on the contrary, it has turned out that the precautions were not necessary. Experience assures us, that a person in good health may be safely inoculated without any preparation, and that all the regulations in respect to diet and the necessary course of medicine, may be sufficiently complied with in the week that intervenes between the operation and the commencement of the disease. With respect to a double infection, that is, by Inoculation and in the usual course of communication, or an accumulation of the distemper afterwards by living with those who are actually labouring under it, no ill consequence need be feared; for I am perfectly satisfied, that after Inoculation is effectually performed, no injury can be sustained by living with others in the most infectious state. And even if the first Inoculation should fail infecting (which if proper care is taken will scarce ever happen) the failure may be discovered on the third or fourth day, and the patient may be inoculated again; and even then, should there be a moral certainty that the natural infection has been taken, it will be in time to prevent any ill effects; the inoculated disease will as it were supercede and annihilate the former infection, and the patient have the Small Pox from Inoculation only.
I am aware that some apology is necessary on publishing opinions that may be deemed improbable in so laconic a manner; this is no place to pursue the subject: but I mean soon to support these assertions by relating certain facts on which they are founded. It is probable, that from a deliberate consideration of these circumstances, some considerable improvements may be made in the regulations of the Hospital.
A principal one should be, to quit the practice of bringing the inoculated patients to reside with those who have the natural disease; a circumstance that could not have been consented to but from the former mistaken opinions which have been noticed. A considerable advantage will also be gained to the œconomy of the Hospital, on account of the time of the patients residence being shortened; by which means a greater number may be inoculated at the same expence.
I hope to stand excused from having made these remarks here, as in the sequel I mean to propose an enlargement of the Hospital at Pancras.
Having taken notice of the most material articles that have occurred relative to this subject, I shall venture, though with much diffidence, to submit some outlines of an Hospital for Inoculation to the public, premising, that in respect to situation, the environs of London do not seem to afford a better spot than that on which the inoculating Hospital at Pancras is built, which, with the ground adjoining to it being four acres, is sufficient for the accommodation of any number of patients for the benefit of the air; in short, every local advantage would be there enjoyed in great perfection: the present building is not however capacious enough for such a purpose, but it may be enlarged, and the whole extent of ground ought to be walled in, to prevent all intercourse with others, or giving any offence to the public; and I have not the least doubt of the acquiescence and assistance of the present governors, to any scheme for the extension of this noble and useful charity, as they have, with a most distinguished application and disinterestedness, employed their best endeavours to promote the interest of the present establishment.