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39
declare itself—and requesting co-operation in measures for
limiting the extension of the endemic. I also communicated
with the head teachers of public elementary schools,
pointing out that modified small-pox is frequently a mild
disease, sometimes scarcely affecting the general health after
the first day or two, so that children who had had such an
attack might possibly be found at school : I described the
symptoms of the malady, and the appearance of the rash,
and requested to be informed of any suspicious case that
might come under notice. I wrote likewise to the Medical
Officers of Health of the adjoining parishes of Paddington
and Chelsea, to put them on the alert. Every case was duly
reported, day by day, to the Vaccination Officer ; and the
Clerk to the Guardians was informed that the outbreak justified,
and even demanded, special vaccination arrangements,
including house-to-house visitation with a view to re-vaccina
tion of adults. At an interview with this gentleman, I
pointed to the necessity for the relief of persons who had
been advised to temporarily discontinue their usual avocations
with a view to prevent the spread of infection, or who had
become destitute through the illness of the bread-winner.
The Guardians, at their meeting on the 2nd November, after
consideration of their Clerk's report, referred the whole matter
to a Committee for enquiry ; meantime directing the Relieving
Officers to accept a written intimation in regard to cases in
which relief appeared to me to be necessary, instead of requiring
an application to be made at the Relief Office from the head
or other member of the family, which might be the means of
bringing infected persons into contact with other people at
the waiting rooms. Large posters, moreover, were printed,
indicating, for the guidance of the public, the Guardians'
ordinary and special arrangements in respect to vaccination ;
and the District Medical Officers were instructed to revaccinate
persons living in infected houses. The special
arrangements included a weekly evening sitting by the Public
Vaccinator to afford facilities for vaccination, and the revaccina-