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12 SANITARY CHRONICLES, 1894.
The general course is plotted out in curve form in the
diagram facing page 13.
Hence, of the 299 cases reported during the year, the
majority of these were derived from the large outbreak in
Portland Town and the subsidiary outbreak in Nightingale
Street, and they fell for the most part in the months of
July and August.
The deaths from smallpox amounted to 29, or about
10 per cent, of the attacks.
Further details with regard to the outbreak have been
already printed and published in the several monthly reports,
and it will only be necessary to recall a few particulars.
The influence of vaccination and re-vaccination in
modifying or preventing attacks, and in diminishing
mortality, was strikingly shown. An inspection of the
schools also proved that there were a large number of
children in the affected areas who had either never been
vaccinated or had not been efficiently vaccinated.
In the Portland Town outbreak, a local office was
temporarily used as a centre to which messages could be sent,
and at which the Inspectors and the Medical Officer of
Health were in more or less constant attendance.
Similarly in the Nightingale Street outbreak, a local
administrative centre was established at the Stone Yard.
The facilities which this system gave were so great that the
experiment, in similar circumstances, will certainly be
repeated.
It was also found useful to employ special medical aid
in visiting from house to house, so as to discover cases
which would otherwise be unreported. Dr. Carter, who
undertook this duty, did, as a fact, discover a few cases
which, had they been neglected, might have formed fresh
centres.
The great lesson, however, which these outbreaks
teach, is the absolute necessity for prompt removal to
hospital. The very fact that the outbreaks were due to