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34
Vaccinated, and whose rash does not appear to have been typical,
was removed on September 27th. On arriving at the Riverside
Wharf, for embarkation on the Ambulance Steamer, the
patient was examined by the Medical Officer in charge; no case
being sent to the Ship Hospital till the certifying practitioner's
diagnosis is confirmed. This gentleman, having formed the
opinion that the disease was chicken-pox, vaccinated the child
and sent her home again. The vaccination did not "take."
The father, Mr. R., had fallen ill a day or two after the baby,
a copious eruption having come out, apparently, on the
27th. On this day the house was visited by the Assistant
Medical Officer of Health, who, seeing the father's condition,
wrote to Dr. B. urging him to notify the case as one of smallpox.
But the child having been sent home as not suffering from
this disease; the doctor, reasonably assuming that the father
and child had the same disease, whatever it might be,
declined to notify the case unless the Medical Officer of
Health himself should confirm the diagnosis. The Medical
Officer, being unwell, requested a medical friend to see the
patients. This gentleman—not knowing the history of the
previous cases, and seeing that the rash was vesicular, the
temperature, moreover, being at the time normal—came to
the conclusion that the disease, in father and child, was
chicken-pox; an opinion which corresponded with that
of the Medical Officer at the Wharf, as regarded the baby.
Dr. B. a few days later reported that the father's rash
had become pustular; whereupon, on October 2nd, the
Assistant Medical Officer of Health, and the consultant,
vvent to the house; but in the absence of Mrs. R. they were
refused admittance by the landlady. Having heard of
the illnesses in this family, and of the connection with
the family of James K., I asked Dr. B. to allow me to see his
patients, and with him I saw them on Friday, October 27th,
a full month after the appearance of the rash. Mrs. R. was
not at home. The baby was convalescent, but the marks of
the rash, not very distinctive however, were still visible.