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17
SMALL-POX
appearance of the eruption. The characters of the eruption were those of small-pox. The man
was removed to the South Wharf Shelters (Metropolitan Asylums Board), and there detained three
days, at the end of which period he was returned to the Workhouse. Unfortunately he was not
sent back to the Casual Wards, but allowed to leave the ambulance at the Workhouse gate. He
at once disappeared, and was not seen again.
In the 15 genuine cases the illness commenced:—
In June, July, August, September, and October, 1 case each.
In November, 6 cases.
In December, 4 cases.
One patient, a man aged 25, had never been vaccinated (see Case No. 4 below); and another, a
girl aged 15, was not vaccinated until she had sickened with her illness. (Case No. 11.)
The histories of the cases, as obtained from inquiries made by the Stuff of Department, are
here briefly recorded.
Case No. 1—A. I., f., 24 years. Onset 10th July; rash out 13th July; to hospital 14th July.
Patient vaccinated in infancy only; one good mark.
The origin of this case was not traced. Patient was a housekeeper in a private family.
E. K., f., 38 years, domestic servant. Removed to hospital 12th July.
E. C., m., age and occupation unknown. Removed to hospital 9th July.
These two cases were removed from St. Marylebone. E. K. had been in service for fivo days
prior to 29th June in the same household as A. I., and E. C. a frequent visitor there. The latter had
been to the house whilst ill.
Case No. 2.— K. T., f., 40, independent. Onset, &c., not known; treated at home. Patient
had been vaccinated three times, the last occasion being about 1879.
This patient arrived in Paddington from Texas, via New York, on 27th June, on which day
she had "chills." The case was reported as one of enteric fever on 2nd July, but on a later day
the diagnosis was revised, in part on account of a negative reaction with the Widal test and in part
on account of the peculiar development of the "spots" which had been observed on 2nd July. These,
according to the statement of the physician in attendance, "matured" and then disappeared. A
consultant was called in, who excluded enteric fever, and, from the history given, inclined to a
diagnosis of "varioloid" (modified small-pox).
Inquiries were made in Liverpool as to other cases among the passengers arriving by the same
steamer, but no case had been heard of. Inquiries were also addressed to New York, and it was
ascertained that small-pox was prevalent when the patient was staying there.
Case No. 3.—H. H., f., 25 years. Onset 23rd August; rash out 27th; to hospital 1st September.
Vaccinated, but no information as to date or amount thereof.
Patient was a domestic servant, whose employers were out of town on holiday. She had been
going about London and elsewhere, and her movements could not ho satisfactorily accounted for.
There were reasons for suspecting that this case was connected with that of—
T. R., m., age unknown, a carpenter, residing in Hampstead. Rash 8th
August; to hospital 14th August,
but it was not possible to prove the suspicion.
Case No. 4.—T. C., m., 25. Onset 7th September; rash (prodromal) 11th September; to
hospital 11th September. Patient a brass-finisher; never vaccinated.
Patient's mother and sister residing in St. Pancras, were removed to hospital ill with
small-pox on 2Gth August; both died, the sister being buried on 6th and the mother on 9th
September. Patient saw his mother at home 22nd August, also at "Ships" 30th August,
vaccination being refused by him on the latter occasion. Patient was at his mother's homo almost
daily up to the time he was taken ill. Patient's wife and child, aged 4 months, were both
unvaccinated, when lie was removed, but were vaccinated on that day and escaped infection.