"Whereas ... the sewage of towns situate on the river Thames above the metropolis is carried into the river, and thereby its waters are polluted and the health and comfort of the inhabitants of the valley of the river below those towns of the metropolis are affected," powers were given for the diversion therefrom of the sewage of Oxford, Reading, Kingston, Richmond, &c., &c., "whose cloacal contributions to the stream were distributed to masses of the people of London." No less than 56 towns, it was said, cast their impurities into the river. And in the following year the scope of the Thames Conservancy Board was extended and very stringent care exercised to prevent unnecessary pollution of the river. And in 1868 the river Lea, another of the water suppliers, was placed under a Conservancy Board. In 1867 an Act of far-reaching consequence was passed, making vaccination compulsory. In 1836 an Act[109] dealing with this matter laid it down that the parent of a child, or the occupier of the house in which a child was born, might, within 40 days, give notice to the Registrar as to the vaccination of the child. There was no punishment for the neglect to do so, and no penalty for refusal to give the Registrar the information. This new Act, which came into operation on the 1st of January, 1868, enacted that-- "Every child shall be vaccinated within three months of its birth." The Act was to be administered by the Poor Law Authorities; and Boards of Guardians might appoint public vaccinators and establish vaccination stations. In 1867, also, another Act of very great consequence was passed dealing with one important element in the sanitary evolution of London, to which no reference has yet been made, namely, the provision of hospitals for the isolation of infectious or contagious disease, for the prevention of mortality, and for the speedy restoration of the sick to health. There is, indeed, no part of sanitary work requiring more constant attention than the protection of the community from the spread of infectious diseases, and this is best secured by hospitals affording proper provision for isolation and treatment of infectious cases. Next to the adoption of proper measures for the prevention of disease, a suitable provision for the speedy restoration of the sick to health is obviously of the greatest importance to the community. So far as the absolutely destitute were concerned, all had, by the law of England, subject to certain conditions, right to food, shelter, and medical attendance; and they accordingly received gratuitous medical treatment at workhouses, or dispensaries, and in sick wards.