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illustrations of this kind have already been given. The
following case is also in point.
Case 49.—John C., aged 19, fell ill about November 1st with the
usual premonilory symptoms of small-pox, and subsequently a few spots
appeared on his face. He was attended by a doctor who did not
recognise the disease, but evidently, after a time, had his suspicions aroused,
as he consulted another doctor who expressed his opinion that the disease
was small-pox. The case was not notified. On 21st November, the
patient's mother (case 50) was attacked with small-pox and removed to
hospital.
In the following group of cases the source of infection was
discovered, outside the parish, in an illness which was not even
suspected by the medical practitioner to be small-pox :
Case 43.—Alice C., aged 18, was removed to hospital November 20th.
Her brother John C., aged 13 (case 61) contracted the disease from her
and was removed December 7th. Upon inquiry it was ascertained that
Alice C., is engaged to Charles P., who lives at Willesden, and is employed
at Paddington Railway Station. This man had left his work ill, on the 30th
October, with symptoms which were undoubtedly premonitory of smallpox.
A rash subsequently appeared on his face and body. A doctor said
he had "blood poisoning," but did not recognise small-pox and the case
was not notified. The patient remained at home for about eight days,
and then returned to his work whilst infective. Alice C. had visited
him on November 5th, 7th, 8th ; and it was probably on the first of these
occasions that she became infected. (It may be mentioned in passing that
Charles P.'s young brother, aged 5, also contracted the disease and that
William B., who lives at Paddington, and works on the railway, visited
Charles P. during his illness and so contracted small-pox.) Arthur G.,
aged 17 (case 32) works with Charles P., and it is suspected that both
patients, and also Thomas G. (case 39) brother to Arthur G., contracted
infection from the same undiscovered source. Subsequently, Emily W.,
aged 27, of 6, Branstone Street, and her brother-in-law Charles W.,
aged 29, of 9, Bolton Road (cases 53 and 54) contracted small-pox and
were removed to hospital on the 27th and 28th November respectively.
The woman had lain ill for some days without medical attendance. The
case coming to Inspector Pettit's knowledge, November 27th, he took a
doctor to see her, and upon his certificate removed her forthwith. She died
of hæmorrhagic small-pox on November 29th. The histories of these two
cases suggested a common source of infection which was found at 407,
Portobello Road, whence cases 32 and 39 had been removed, and where
the two sufferers had been accustomed to visit the mother of the female
patient.