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three, all of which have to pass through a portion of the docks, viz.: by Rotherhithe Street on
the north, Commercial Dock Road on the west, and Plough road on the south.
At each of these roads there are bridges which are occasionally opened to allow ships to enter
the Docks, and where ambulances and other vehicles are liable to be detained, occasionally as
long as twenty minutes.
In Rotherhithe Street the houses are continuous, except at the entrance to the Docks known as
Lavender Bridge, with the rest of the Borough, since Rotherhithe Street is part of a long
straggling thoroughfare, running from one end of the Borough to the other, along the river.
From this peculiarity of position this area is locally known as "Down Town." The South
Wharf itself was originally intended to act only as a place of embarkation for small-pox patients,
which were being removed to the ships at Long Reach. The accommodation was increased during
last winter, and there are now shelters for isolation of doubtful cases. Owing to the number of
patients in the recent epidemic, and the constant influx of patients at all times during the day
and night, the wharf could hardly ever be said to be entirely free from cases temporarily detained
there en route for the hospital ships.
Steam boats proceed down the river with patients three times in the twenty-four hours.
Owing, however, to the fog on the river, these boats are occasionally detained at the wharf for a
considerable period.
This happened three times during last winter, when the boats, and all available beds in the
shelter, became crowded, thus affording all the conditions favourable to the spread of small-pox
in the neighbourhood by aërial diffusion of infection, if such exists. In the following Table will
be found the result:—
Table. V. —Detention of Small-Pox Patients at South Wharf through Fog.
Rough approximation
of number
of patients
detained.
Direction of Wind.
No. of days
between detention
and case.
Direction of
house as
regards
South Wharf.
Date.
Date and address of first
case after detention.
Morning.
Afternoon.
N.N.W. and N.E.
S.
Nov. 4, 1901
20
E.N.E. and calm
Dec. 3, Odessa Street
29
N.W., variable aud
calm
„ 5, „
30
Calm, N.N.E.
Do.
28
S.
„ 6, „
40
S.S.W.
S.W.
Do.
27
S.
„ 7, „
60
S.W.
S.S.W.
Do.
26
S.
„ 15, „
20
N.W. and S.S.W.
S.S.W. and S.S.E.
Do.
S.
18
40
Variable and calm
Variable & S.S.W.
Do.
„ 16, „
17
S.
40
S.W. and S.E.
S.E., E., E.N.E.
Mar. 4, 1902
Apr. 26, Faustin Place
53
N.
120
E.
„ 5, „
E.
Do.
52
N.
N.N.W.,N.E.,S.W.
„ 6, „
40
Calm and variable
Do.
51
N.
A single glance at this Table shows that no harm resulted to the inhabitants of the neighbourhood
from this detention, and that what cases did occur could not be put down to this,
with one possible exception, since they occurred after the incubation period of twelve to fourteen
days, which elapses from the receiving of infection to the development of symptoms.
This exception would be cases Nos. 2, 3 and 4 of Table VI. Although notified at the same
time, No. 3 was at a more advanced stage when removed than either 2 or 4. No. 3 made a
statement when he returned from the hospital to the effect that when he went down there
he met two men who had been working on the same ship on which he worked at Millwall.
These men would therefore have contracted the disease prior to No. 3. I have not been
able to confirm this story, because the cases did not occur primarily on the ship, or else
they would have been known to the Port authorities. It is quite possible, however, that
they may have belonged to some other district in London, and have been working on this
ship, when they might easily have escaped the knowledge of the Medical Officer of Health of the
Port. As the patient has gone out of the district, I have been unable to get the name of the ship.
If this is true, and I have no reason to doubt the man's statement, it would afford some clue to
these cases. Even if it is not true, it will be seen from Table V. that the wind was blowing from
the house towards the wharf on November 16th, when infection might be supposed to take place;
further, it is highly improbable, even had the infection travelled all that distance from the
wharf, that it would have picked out a house at the end of the street farthest from the wharf,
when it would probably meet with many susceptible subjects, not only in the large timber yard
it would have to pass through, but also in the street, before it reached the house in question.
It might be objected to this, that when there was fog on the river there could be no wind. This,
however, is not the case, as even during the presence of a fog there is always a slight and variable
breeze on the river, and the fog does not always remain at the same density, inasmuch as it
frequently partially lifts, but not sufficiently to allow the ambulance boats to start, and then
becomes dense again.
But even were there no breeze at these times, it would only mean that a greater accumulation of
infection would take place at the wharf, which would show its effect as soon as the fog lifted. In
addition there is an Elementary Church School right opposite the wharf gates, the distance between
the latter and the school door being some sixteen yards. During the play hours the children are
constantly running about looking at the ambulances, and have been seen occasionally trying to
look into them from the step. Out of the 130 children attending here, not a single one has