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adjoining Baker Ward developed suspicious rashes, and were put
into the isolation ward for observation. One of these cases turned
out to be small-pox, and was sent away; but the other still remains
in the observation ward, and the rash is deemed to be an iodide
rash. On March 16th another patient in Baker Ward definitely
developed small-pox, and was also sent away, and in the afternoon
of the same day a case was found in Davis Ward, and was treated
in the same fashion. Since then no other cases have occurred,
but the following precautions are still in force:— Baker, George, and
Davis Wards are all kept in strict quarantine, and cases are
neither admitted nor discharged. The house physician in charge
of the wards keeps himself isolated, as also do the nurses; while
the visiting physician visits no other wards. The nurses, porters,
and patients belonging to the wards have been vaccinated, and the
only patient who refused vaccination was discharged, and his
name given to the medical officer of health. If no other cases
occur in the infected wards it is considered that quarantine may
be raised about the end of this month. Special instructions have
been given to the receiving-room officers to keep a sharp look out
for any other cases which may present themselves among the
casualty patients, and a hut has been prepared for the instant
isolation of any case which may be recognised, while Dr. Thomas,
the medical officer of health for Stepney, has promised to attend at
once and inspect any case which may seem to be merely suspicious.
As a result of the investigation which he made upon being
apprized of the first case identified in the wards, Dr. Thomas
visited the Bouvier family and found reason to send to the smallpox
hospital Bouvier senior, his son and daughter, and the landlady
of the house in which they all lived.
Fresh centres of infection continued to be discovered,
notwithstanding our efforts to localize the
disease. William Cooper, a barber, aged 61, was
removed on March 20th from 399, Bethnal Green
Road; a number of his customers resided in the
infected area, and probably conveyed the disease to
him. Mary Attfield, of 38, Middleton Street, was
reported to have chicken-pox. On visiting I found she
had well marked confluent small-pox; she was removed
to hospital, but died the following day. I