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outside sources are the City and other Metropolitan
Boroughs (Stepney, Southwark, Holborn, City of Westminster,
Wandsworth, Marylebone, St. Pancras, Battersea,
Greenwich, and Camberwell), St. Albans, Raynes Park,
Erith, Swanscombe, Maidstone, Chingford, Dartford,
Tottenham, Hertford, Hendon, and Hoxton.
2. Smallpox was spread within the Borough itself on 202
separate and distinct occasions, viz.:—Work-places in
Lambeth 27, " contacts " with notified Lambeth cases of
Smallpox 108, modified Smallpox unrecognised and treated
for some other disease 66, infected laundry 1.
3. In 49 cases (i.e., 12.1 per cent.), the sources of contagium
could not be satisfactorily traced.
Arising out of the above, the following remarks call for attention : —
1. The Metropolitan Asylums Board (as the Hospital Authority
for London) has done much good work in connection with
the removal to, and treatment in, Hospitals of notified
Smallpox patients, but the disease throughout London has
undoubtedly been spread through workmen, who had not
been previously protected by vaccination, being allowed
to work on the Board's Hospitals Extension at Dartford,
near to the existing Smallpox Hospitals, which were at the
time occupied by Smallpox patients. In this way, and
from this source, many cases of Smallpox have occurred
throughout London and elsewhere (5 such workmen sickening
in Lambeth Borough alone). The Borough Council's
Medical Officer (and others) protested to the Board at the
time against this preventible state of affairs being allowed
to continue, with the result that it was eventually stopped,
and only re-vaccinated men employed on dangerous works.
Two cases of Smallpox occurred in Lambeth within 12-14
days of the return from the Smallpox Hospitals of two
different patients, and may be causally connected therewith
as return cases of Smallpox.
2. Workshops and work-places have proved common sources
from which Smallpox has spread—88 cases being traced
to work-places outside Lambeth and 27 to work-places inside
Lambeth, making a total of 115 cases, i.e., over a
fourth of the whole number of cases notified.
3. "Contacts" account for 156 cases, 108 connected with
patients suffering from Smallpox within the Borough, and
48 with patients outside the Borough.
4. The difficulties of diagnosing Smallpox in its protean modified
forms have been dealt with elsewhere in the Report,