London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Kensington 1904
The annual report on the health, sanitary condition of the Royal Borough of Kensington, etc., etc., for the year 1904
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The actual figures, showing loss, both for the Metropolis and the rest of England, during the twenty years 1882-1901, as set out in the report of the Local Government Board for 1902-3, are as follows:—
| Metropolis. Cases lost. | Rest of England. Cases lost. | Metropolis. Cases lost. | Rest of England. Cases lost. | ||
|---|---|---|---|---|---|
| 1882 | 6.6 per cent. | 4.5 per cent. | 1892 | 18.4 per cent. | 14.3 per cent. |
| 1883 | 6.5 „ | 4.9 „ | 1893 | 18.2 „ | 15.7 „ |
| 1884 | 6.8 „ | 5.3 „ | 1894 | 20.6 „ | 19.0 „ |
| 1885 | 7.0 „ | 5.5 „ | 1895 | 24.9 „ | 19.8 „ |
| 1886 | 7.8 „ | 6.1 „ | 1896 | 26.4 „ | 22.3 „ |
| 1887 | 9.0 „ | 6.7 „ | 1897 | 29.1 „ | 21.6 „ |
| 1888 | 10.3 „ | 8.2 „ | 1898 | 33.0 „ | 19.6 „ |
| 1889 | 11.6 „ | 9.6 „ | 1899 | 27.7 „ | 15.4 „ |
| 1890 | 13.9 „ | 10.9 „ | 1900 | 25.8 „ | 13.9„ |
| 1891 | 16.4 „ | 12.9 „ | 1901 | 24.1* „ | 11.2 „ |
These figures show both the great increase in annual " loss," from 1882 onward to 1898, and
that the new Act, which came into operation in 1899, has brought about a considerable increase in
the number of primary vaccinations. The cost to the country has been great, but the Act clearly
has justified the policy of the Local Government Board, at whose instance it was introduced. The
Board, in their annual report for 1901-2, referring to the vaccination returns for 1899, observed that
"the increased acceptance of primary vaccination "—at a time precedent to the last epidemic of smallpox—is
to be "referred to the altered conditions under which, consequent upon the Vaccination Act,
1898, and their regulations made thereunder, vaccination is now performed, and the increased
facilities which now exist for its performance." One of the most potent influences tending to
the increase in the number of vaccinations in normal years, is the provision made for the use of
glycerinated calf-lymph, which has cut the ground from under the feet of those who objected to
vaccination because of the possibility of enthetic disease being conveyed in humanized lymph.
Vaccination Authority.—The question as to the future vaccination authority was brought to
public attention in the early part of 1903, by a deputation of the Imperial Vaccination League
to the President of the Local Government Board. The deputation and the President were agreed
as to the desirability of transferring the administration of vaccination law from the Boards of
Guardians to some other authority. The President, however, did not commit himself as to what
that other authority should be; and, with other questions, this one stands in abeyance, pending
fresh legislation.
Calf Lymph.—The statutory duty of the Local Government Board in respect to the supply of
lymph, only requires them to provide for the needs of public vaccinators for primary vaccinations;
but the Board in practice provide the lymph required for re-vaccinations also. And this is a necessity;
for arm-to-arm vaccination, i.e., the use of humanized lymph, is discouraged, and indeed is now
impracticable owing to the abolition, generally, since 1899, of public vaccination stations. The
President of the Board informed the deputation referred to in the preceding paragraph, that it
would be impossible to supply lymph to all medical men. But having regard to the enormous
production of the lymph during the small-pox epidemic in 1901-2, one cannot but think that such
a supply as was indicated by the President—50,000 charges a week—equal to 2,600,000 charges
a year, would suffice for all requirements. In 1902, public vaccinators made 82,214 applications for
calf-lymph, and 962,000 charged capillary tubes were sent out. These officers were accountable for
just under 50 percent, of the vaccinations performed in that year at the public expense, and I think
it reasonable to assume that the needs of private practitioners would have been amply met by the
balance of more than one and a half million tubes.
Re-vaccinaiion.—The most pressing need of the time, as regards protective measures against
small-pox, is a provision for promoting re-vaccination of children at twelve or thirteen years of age
—a time of life at which the protection afforded by infant vaccination is beginning to be, or has
been, largely impaired. This question also was dealt with by the deputation to the President of the
Local Government Board from the Imperial Vaccination League in 1903. The plan has long been
practised in Germany with the result that small-pox amongst the natives of that empire is almost
unknown. The President made no revelation of the intentions of the Government, nor, indeed,
of his own views, which he thought it more prudent to suppress till the time for action should
have come.
*This is the percentage for the Metropolis as a whole. In several of the unions the percentage of cases not finally
accounted for was exceedingly high : for instance, in Mile End Old Town it was 65 8, in Bethnal Green 518, in Poplar 48 7, in
Shoreditch, 44-4, and in Stepney 43-9.