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I may make one or two supplemental remarks to the
above report. In the first place both it and the table
(especially the latter) are incomplete, mainly as regards
facts as to vaccination. The fact is, in many instances the
cases were removed to hospital before we had any
opportunity of investigating this point. It is of the less
importance however, because Dr. Luff was appointed by
the Vaccination Commissioners to investigate and report on
the small-pox epidemic in London, and before long such
information as could be obtained from local sources in regard
to small-pox, and the additional information derivable from
the Asylums Board Hospitals will be collected in a comprehensive
paper. In the next place, in the comments made
as to the return of cases of suspected small-pox by the
Asylums Board Officials, there is no intention of imputing
blame. Small-pox, especially as modified by previous
vaccination, is often exceedingly difficult, and even impossible,
to recognise with any degree of certainty. I would
certainly not pretend to be able to diagnose the disease in
all cases. But it is important to mention the fact; the more
especially as one of the returned cases formed the middle
one of a series of three occurring at 48, Brymer Road. The
first of these cases was removed at an early stage to the
workhouse, whence it was removed in the course of a day or
two to the Asylums Board Hospital. The second case was
attacked twelve days later, and was the case sent to and
returned from the hospital. The third case broke out
twelve days later. The intervals between the attacks
corresponded exactly to what should have happened had
the first infected the second, and the second infected the
third. In the third place it is mentioned that one of the