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opportunity of seeing cases of the disease, mistakes of this
nature must almost of necessity be not infrequent. Thus, in
1891, of 90 patients throughout London certified to be
suffering from Smallpox, and removed from their homes by
the Metropolitan Asylums Board's ambulances, 27 or 30
per cent, proved not to have Smallpox. In 1892 out
of 412 cases, 93, or 22 per cent, were similarly found to
have been incorrectly certified. It is, however, obvious that
as the arrangements of the Managers for removing patients
are so admirable, that there can be no danger to the patient
in removal, and as the patient is not allowed to proceed to
the Hospital Ships, and so be exposed to infection, until the
diagnosis is confirmed, it is better where means of complete
isolation are wanting that doubtful cases should be at once
notified, so that they can be promptly removed and isolated,
than that the risk should be run of spreading the disease
broadcast by the neglect, or the impossibility of taking
proper precautions."
In most of the other instances where the disease was
communicated by persons suffering from it in an unrecognised
form, the disease had been of such a mild nature that no
medical practitioner had been called to the first case.
With regard to the Langford Road case it is worthy of note
that though the child D. M. was about while the rash was
visible and played during that time with probably dozens of
other children, only four were infected, and of these three
were unvaccinated. As showing how Smallpox may be
spread, and how difficult it may be to trace the source of
infection, it may be mentioned that F. S., who originated
the disease in Ashington Road, was about during the whole of
the time he was suffering from the disease, and that he was at
a Music Hall on the fourth and on the fifth days of his illness.
All the cases, excepting the two in Greyhound Road, who
had really recovered before they were notified, were removed
to the Metropolitan Asylums Board's Smallpox Hospital.
Mortality. —Three cases terminated fatally, two being
unvaccinated.
The following Table gives a synopsis of the particulars of
the cases: —