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extremely prevalent in St. Pancras (615) and Holborn (435)—all
four Boroughs coterminous with our boundary — we have not
suffered much more than has been the case.
(b) Prompt Recognition and Early Isolation.—In my Annual Report
for Finsbury, 1901 (pp. 41-43), I have discussed the diagnosis of
small-pox and chicken-pox, and the matter need not be further
dealt with. What has been said respecting channels of infection
speaks for the importance of prompt recognition and early isolation,
and of the enormous and immediate effect that such circumstances
have upon the spread of the disease. There can be no doubt that
early recognition and isolation has been the secret of our success in
Finsbury. If it had not been for this it is certain that the epidemic
would have been more widespread.
The early diagnosis of small-pox is of the utmost importance, and
immediate notification should follow its detection. For isolation to
be of value must be prompt, and prompt isolation depends upon
prompt recognition. Every case of small-pox unnotified, and,
therefore, not removed to hospital, acts as a centre of infection, and,
of course, the longer it remains so the greater is the opportunity of
infection. Moreover, it should be borne in mind that the infectivity
of small-pox increases daily after its commencement.
(c) The State of Vaccination of the Community.— It is a difficult
matter to measure with any exactness the condition of the
community as to vaccination, on account of private vaccination,
and on account of there being no standard as to the number
of marks. We can only arrive at an approximate opinion from
the facts which we have, to which reference will now be made.
The Vaccination Officer for the Holborn Union (Mr. T. J. Garstang)
has furnished me with the following returns, showing the percentage
of primary vaccinations on the registered births in decennial periods
since 1870. The returns in the possession of the Holborn Guardians
of the Poor are not, unfortunately, complete, and yet this is the only
indication we have as to the state of the vaccination of the
community. I select the figures at the decennial periods as
illustrative of all the returns since 1870 :—