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60
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 sicken.
ing in Lambeth Borough alone). The Borough Council.s
Medical Officer (and others) protested to the Board at the
time against this preventable 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 there.
with 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 in.
side 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 modi.
fied forms have been dealt with elsewhere in the Report,
and in this connection 65 cases have arisen from patients
suffering from Smallpox but diagnosed as suffering from
other diseases, e.g., Chickenpox and Influenza.
5. The part that tramps or vagrants play in disseminating the
disease, not only from one part of a district to another, or
from one workhouse to another, but also from one town to
another, is well known, and of the 404 cases in Lambeth, 9
were tramps who introduced the disease. The Lambeth
Workhouses have been exceptionally free, on account of
the adoption of the Borough Council.s Medical Officer.s
suggestions, and the untiring energy displayed by the
Guardians. own Medical Superintendent (Dr. Quarry) in
practically carrying out such suggestions. On 8 separate
occasions a Workhouse or Infirmary was infected, but in
no single instance did the disease spread, on account of
strict isolation by removal to Hospital, disinfection, and