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In a certain number of cases the source of infection could be more or less distinctly traced,
and in a larger number it could only be vaguely conjectured or not traced at all. Of the firstclass
there were 114, and these can further be divided into primary and secondary cases. By
primary cases are meant first cases in a house or family, and of these there were 23. These in
their turn gave rise to 91 secondary cases. In Table IV. will be found particulars of the
primary cases. This list does not include a few cases which occurred near the wharf, of which
the origin was probable, but still doubtful, and which are alluded to later, under the subject of
aërial diffusion.
Table IV.
No.
Date.
Initials.
Sex.
Address.
Source of Infection.
1901
Oct. 24
W.N.
M
Ernest Street
Disinfected infected house, October 12th, 1901.
1
2
„ 23
G.W.
F
Wolseley B'ld'gs.
Brother works at South Wharf, and visited here.
3
„ 24
W.P.
M
Ernest Street
Disinfected infected house, October 12th, 1901.
4
„ 26
E.K.
F
Fair Street
Visited infected house, Limehouse, October 13th, 1901.
5
„ 27
C.E.M.
F
Mellicks Place
Mother lives in infected house, Farthing Alley.
6
„ 28
T.M.
F
Dockley Road
Grandmother to first cases in Bermondsey and visited
Farthing Alley
7
„ 28
M.H.
F
Wolseley B'ld'gs.
Worked with Mrs. D., Eckett Street, who had previously
developed small-pox.
M.N.
8
„ 29
F
Monarch B'ld'gs.
Patient washes for Mrs. J., who lives in infected house;
patient's mother is also visited by Mrs. J.
M
9
W.L.
„ 29
Webb St. B'ld'gs.
Two previous cases in workplace, Crayford. [area.
10
Nov. 2
H.L.
M
Fort Road
Pawnbroker's assistant—received articles from infected
11
F
„ 12
M.S.
Parish St. W.H.
Notified from Camberwell as small-pox, October 30th,
1901; returned from South Wharf as chicken-pox, and
subsequently developed small-pox. Vaccination performed
at Wharf, October 12th, did not take
properly. Evidently became infected during stay of
day or two at Wharf.
„ 16
M
12
A.H.
Guinness B'ld'gs,
Pages Walk
Relations removed with small-pox from New Church
Street 14 days previously. Patient employed in
infected area.
Dec. 2
1902
J.H.N.
13
M
Rouel Road
Several previous cases at workplace, Holborn.
Jan. 20
14
K.C.
F
Abbey Street
Visited house in Larnaca Street where two cases
had occurred.
15
Feb. 3
A.S.
F
Weston Street
Came from lodging-house in Borough where several
cases had occurred previously.
„ 24
16
F.L.
F
Long Lane
Previous case in workroom, Shoreditch.
17
Mar. 4
H.D.
F
Gareth Place
Visited, 14 days, before infected house in same Place.
18
„ 12
L.D.
F
Larnaca Street
Infected in Camberwell before coming here.
19
Apr. 4
G.H.
F
St. Helena Road
Husband worked in Purfleet, and 14 days before had
unrecognised attack of small-pox.
May 12
20
B.H.
F
Larnaca Street
Took in basket making from infected housein same street.
21
J.R.
M
Clarence Street
„ 12
Friends of infected family in same street.
22
Apr. 19
E.F.
F
Bermondsey Wall
Infection from unrecognised attacks in several members
of family. These were treated as influenza with a
slight rash.
23
June 11
H.R.
F
Adams Gardens
Infected by fellow worker who attended workplace while
suffering from supposed chicken-pox, but was really
small-pox.
Subtracting these primary and secondary cases from the total of 297, there are left 183 cases
of uncertain origin. This only illustrates the extreme difficulty of tracing the source of infection
in the majority of small-pox cases. From the experience gained in endeavouring to do this, I do
not think enough stress has been laid upon unrecognised attacks. How is it possible, in considering
the number of people with whom a patient may have come in contact to exclude unrecognised
cases among the latter? There is scarcely any infectious disease where the range of virulence
from the mildest to a fatal attack is so great, and I do not doubt that many people, mistaking a
mild attack with perhaps one or two spots, for a "chill," or "influenza," or some other everyday
complaint, have continued during the attack to go about in trams, buses, and other public
conveyances infecting others.
The reason why such cases do not play much more havoc is that the majority of people with
whom they come in contact are more or less immune, either naturally or through vaccination, or,
if not fully immune, require, I do not doubt, a certain maximum dose of the poison before
becoming infected.
This brings me to another very important subject,. viz., the aerial diffusion of small-pox.
Aërial Diffusion of Small-Pox.
In discussing this part of the subject, the influence of the South Wharf on the region
immediately surrounding it, the attack rate of which was greater than any other part of the
Borough, necessarily comes under review.
I think it is now admitted by all medical men, that the infection of small-pox can give rise
to the complaint without actual contact, since the poison is mostly inhaled, and more rarely