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16
SMALL-POX.
(635 increase), and of typhus fever (6 increase). The other diseases were below their averages,
notably scarlet fever (3,123 cases fewer), and erysipelas (1,598 cases fewer).
The sickness-rates for the various diseases during 1901 are given in the same table (Table 17)
for the Borough and the Metropolis. With the exception of puerperal fever (Paddington rate 0.07,
Metropolis, 0.05), the local rates were under those for the Metropolis. The total rate for the
Borough (7.70 per 1,000) was 1.16 below the Metropolitan rate (8.86).
Table 18 shows the sex-age incidence of the diseases, and the number of cases of each disease
from each ward will bo found in Table 19 (page 31). The highest ward rate was that of Harrow
Road "Ward (9.39), those of Queen's Park (9.36), and of Church Ward (9.ll) being very near
thereto.- The lowest rate was that of Lancaster Gate West Ward (3.54). The rates for the
individual diseases will be dealt with later on.

The 22 cases recorded were 17 in excess of the number recorded in 1900, and 8 in excess of the
decennial average. The cases reported from the Registration Sub-Districts were:—
Registration
Sub-District.
Averages.
1901.
1891-95.
1896-00.
1891-1900
St. Mary 18 22 1 11
St. John 4 3 1 2
North-West Paddington — 2 — 1
The actuaLnumbers of cases in each of the years 1891-1901 will bo found in Table III. in the
Appendix (page 66).
In the Metropolis 1,706 cases were recorded last year, being 1,617 more than the number
recorded in 1900 (89), and 1,146 in excess of the decennial average (614). In the first
quinquennium, 1891-95, the average was 1,208, and in the second, 1896-1900, 104. The number
of cases recorded last year (1,706) has only been exceeded once, viz., in 1893, when 2,813 cases
were recorded. The smallest number of cases recorded in any year has been 29, recorded in 1899.
The sickness-rates for this disease based on the notifications, as received, were 0.15 and 0.38
per 1,000 persons for the Borough and Metropolis respectively.
In the adjacent districts, the recorded cases exceeded the number reported in the Borough, in
Westminster (101), and Marylebone (79), the corresponding sickness-rates being 0.55 and 0.59
respectively. (See Tablo 16.)
The time has not yet arrived to write the history of the outbreak which threatens to be the
largest since the memorable epidemic of 1871-72. On this occasion it must suffice to record brief
particulars of the cases reported, and the action taken to limit the spread of the disease.
Having regard to the comparative rarity of small-pox during the past years, it is to be
expected that many practitioners would have difficulty in recognizing the disease, some of whom
had (and probably still have) not seen a case. The text-book descriptions are of little use in the
diagnosis of the more important varieties—namely, those modified by vaccination.
Of the 22 reported cases, 7 were erroneously diagnosed, most of the latter being cases of
chicken-pox—a disease which was widely prevalent during the latter half of the year. To mistake
chicken-pox for small-pox is a triviality, the reverse an accident which has led to very serious
consequences. Included in the 7 cases is one which is worth a brief note:—
On 17th December, a man, aged 40, was found in the Casual Wards with a scanty eruption
on the face. There was an indefinite history of slight illness for some three days prior to the
* All rates, except when otherwise stated, are per 1,000 persons estimated living at the middle of 1901,