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Animal Report of the Medical Officer of Health,—1894. 15
Water or food becomes polluted from contact with infected sewage or infected
sewer air. Tne poison may be taken into the system either through the medium of
the stomach or by the lungs.
The number of deaths in St. George's from typhoid fever in 1893 was four in
excess of its proportion of total London deaths according to its population (vide
table XI.)
Small-pox.—This disease was prevalent in the northern and midland towns of
England during 1892, and became epidemic in London in the winter of 1892-3.
A single case was notified to me in December, 1892. The patient—a tramp—
contracted the disease in Pentonville Prison and the rash was detected on him in the
bathroom of St. George's Workhouse. The fears expressed by me at the end of 1892
that small-pox would probably become prevalent in London during 1893 have
unfortunately been justified.
During the period mentioned there were 206 deaths notified in London, and
2,378 cases entered the Asylum hospitals. This is the largest number of deaths
since 18H4 and 1885, when there were as many as 1,251 and 1,403 deaths respectively
from small-pox.
The epidemic was most prevalent in the early spring, and reached its maximum
in May. There are certain points in its behaviour worthy of notice, such as
(a) its origin and spread during November and December, 1892, and the first four
months of 1893, by the agency of male vagrants ; (b) its subsequent distribution
amongst the residential population, particularly in the poorer parts; (c) the
| important part played in the spread of the disease by the unregulated Salvation Army
and other shelters.

It should be noted that cases are here referred to the places of original infection,
and not to those from which they were actually removed.
Class (d) Under Salvation Army Shelters, includes cases referred to shelters at
which a few people only were infected, such as Stanhope-street, Clare Market,
Quaker-street, Spitalfields, Royal Mint-street, St. John's-Square, Clerkenwell, West
India Dock-Road.