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Reference II.—Means other than Vaccination for diminishing the
prevalence of Small-Pox.
We are quite unable to agree with those who have maintained
that sanitary measures have little or no influence upon Small-Pox.
We have already given our reasons for thinking that the teaching
of the early sanitarians, like Howard and Haygarth towards the
close of last century, initiated a new line of thought in the
prevention of disease, and we believe the general improvement of
the public health, which then set in, was due, in a large measure,
to a greater sanitary activity, and that the falling off in the death
rates of fevers and small-pox, as well as in the general death
rate, is confirmatory of this view.
In speaking of sanitation we use the word in its widest sense;
we are not speaking merely of drainage improvements, but we
include the prevention of overcrowding on areas, or within houses
and rooms, the proper constructions of dwellings, so as to permit
thorough ventilation; the promotion of cleanliness by adequate
water supply and the prompt removal of filth accumulations.
Related to these measures, but in a somewhat different category,
are means directed against contagion, the speedy separation (in
suitable hospitals) of the infected from the healthy, the disinfection
of persons and things, and the prevention of the
propagation of the disease by inadvertent carelessness or by
intentional inoculation.
If the view that attributes small-pox exclusively to contagion
be well founded, it might indeed be possible to keep out the disease,
even from insanitary places, by rigid isolation; but experience shows
that some, even of the contagious diseases, are dependent for
their extension and severity upon influences other than contagion.
The Royal Commission on Infectious Hospitals in 1882, in their
report, called attention to the fact that the opportunity for
contagion which the presence of a small-pox hospital might afford
to a particular neighbourhood, is insignificant as compared with
other deleterious influences from which London suffers. The