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occurs through inoculation. The distance, however, through which it can travel, and still infect,
has been for a long time the subject of much controversy. Judging by analogy with other
infectious diseases, and seeing that in all infectious diseases one must inhale a certain amount of
the poison before the disease, as it were, "takes root," one would not expect the infection of
small-pox to be potent at more than a short distance. In this disease, for instance, I should
expect people in the same room, or house, if not too large, or those visiting hospital wards or
going close to a large amount of infective material, or coming in contact with people whose
clothes are infected, to be attacked with small-pox if not immune already.
This is not, however, what is meant by aërial diffusion. It is the conveyance of the poison
of small-pox in a sufficiently concentrated form to infect susceptible subjects at long distances, say
from one or two hundred yards up to
three or four miles. To explain this
fully I here reproduce the diagram
made by Dr. Power, of the Local
Government Board, in his report to the
Board on the prevalence of small-pox
in Fulham in 1885.
The report relates to the period
between May 25th, 1884, and September
26th, 1885.
Taking the small-pox hospital as a
centre, he divided the neighbourhood
into special areas by concentric circles,
distant ¼, ½, ¾ and 1 mile respectively
from the hospital.
These circles were again divided
into quadrants, and the figures in the
diagram represent the percentage of
houses attacked. The greater prevalence
in the ¼-mile circle, under this
view, would be due to the greater
concentration of the poison. It is
suggested that the greater incidence
in the south-east quadrant was due to
the fact that the north-west wind was
most prevalent at that period.
Dr. Power's report shows that this influence was exerted when the acute cases were restricted
to twenty, and on one occasion was marked when there were only nine cases, of which five were
acute. Other writers have followed in the same strain, the latest contribution to the subject
being the report to the County Council of Essex, by their Medical Officer, Dr. Thresh. To put
his views briefly, he attributes the greater part of the prevalence of small-pox in the Orsett
Union in Essex, to the presence of a large number of acute cases of small-pox in the ships of the
Metropolitan Asylums Board, anchored about half-a-mile from the nearest houses in Essex. He
considers this view strengthened by the fact that during the eight months ending April, 1902,
under consideration, the most prevalent winds blew from the south-west, and west south-west,
from the ships over the south portion of Purfleet hamlet, and that these winds presumably
carried the infection over this long stretch of water.
In view of the fact, which I have previously shown, that it is difficult to trace the source of
infection in a large number of the cases of small-pox ; that it is almost impossible to exclude
communication between a hospital and the surrounding neighbourhood ; from the analogy with
other infectious diseases, and the additional fact that the infection of small-pox is most
commonly acquired at short distances, we should hesitate to accept the theory of aërial diffusion
from small-pox hospitals through such long distances, without the most uncontroversial proof of
the impossibility of the acquisition of infection through shorter distances.
Without criticising these views in detail, I propose giving a short account of my experience of
the South Wharf, which is situated in this Borough, mentioning the conclusions which may
be drawn. I shall be mainly concerned with stating the facts as far as I could ascertain them,
so that the reader can draw his own conclusions from them.
The Borough of Bermondsey is roughly 2¼ miles long by 1 mile broad. The long axis runs
due east and west, the short one being at right angles, viz.: north and south. It is bounded on
the north side by the river Thames, which runs approximately east and west. At the north-east
corner of the Borough, the river takes a curve due south, and bounds the east end of the
Borough for about ¾ mile.
About the centre of this end is situated the South Wharf of the Metropolitan Asylums Board.
The Wharf itself, therefore, faces east. It is surrounded closely by houses to the west and
north, those on the south being separated by a large timber yard.
There are, of course, no houses on the east, but here ships and barges are constantly passing,
many of the latter being commonly anchored quite close to the wharf.
Taking this as a centre, there are within the area, having a quarter of a mile radius, some 320
houses. By extending the radius to half-a-mile there are only 56 more added. This group of
houses is for all practical purposes separated from the rest of the Borough by the Surrey
Commercial Docks, which occupy 360 acres. The population, at a computation of 8 persons to
a house, is 2560 (the percentage for the Borough being 8.2). The methods of communication are
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