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Report of Medical Officer of Health.] 13
L. D., the widow of J. D., was admitted to St. George's Workhouse, Fulham, on May 10th.
She was discharged thence May 16th, and went to B --- St., Fulham Road, whence she went on
May 18th to S --- St., Chelsea. From the latter house she was removed to the Hospital Ships ill
with small-pox on May 21st. An attendant of the ward to which L. D. was admitted at the
Workhouse was sent to hospital with small-pox on May 23rd. Two cases of small-pox were
admitted to the Ships (on May -30th and June 1st) from B —— St., both being grandchildren
of L. D.
J. D.'s funeral on May 12th was attended by his son — D., from Northampton. On May 25th
the son ( — D.) was taken ill, and his illness was diagnosed as " eczema," and a nurse sent for to
attend to him. — D.'s baby was taken ill on June 8th, and his servant on June 9th. The latter
went to her home and was seen by an independent practitioner, who diagnosed her illness as smallpox.
This led to the correct diagnosis of the two earlier cases. The nurse who was called to
attend to — D. sickened on June 13th, and was diagnosed ill with hemorrhagic small-pox on
June 18th. Her case terminated fatally.
The linen of the household in which J. D. was in service was sent to a laundry in one of the
western suburbs. Four girls, J. M., II. W., N. B., and B. L., employed in sorting dirty linen at the
laundry, were taken ill with what was at the time thought to be " chicken-pox." The cases of
H. W. and N. B. were not notified, and the patients remained at home, but no further cases were
traced back to them. J. M. infected her sister-in-law and her mother, both cases being recognized
as small-pox and sent to the Ships. J. M. was not removed to hospital at first, but a month later
she went to the Ships to see her mother, and was then detained as infectious with small-pox by the
Acting Medical Superintendent. B. L. was not removed to hospital, and infected four of her
relatives who resided with her.
Although the death of J. D. was certified as due to measles, the conclusion that his illness was
really htemorrhagic small-pox is irresistible, having regard to the succession of undoubted cases
traceable to his death. How E. D., who died in St. Mary's Hospital, became infected has not been
explained. J. D. and L. D., his wife, were on friendly terms with E. D., but the latter had been ill
for some weeks prior to her admission to St. Mary's Hospital, and, so far as could be ascertained,
L. D. had only once (date unknown) visited E. D.'s flat during the illness of J. D., and on that
occasion it is said that L. D. did not enter the flat. On the other hand, it is said that E. D., who
was in a state of fear that she would die of the same complaint as J. D., frequently remarked after
the death of J. D., that she saw him with his swollen face beckoning her to come to him. If that be
so, especially if E. D. spoke of J. D.'s " swollen face," it is eminently suggestive of E. D. having
seen J. D. just before or after his death. It was stated that when the room occupied by J. D. was
disinfected (sulphur fumigation), the fumes found their way up into the bedroom which E. D. had
occupied prior to May 11th, the latter room being immediately over J. D.'s room.
Too long an interval had elapsed after J. D.'s death to trace the source of his illness. It can
only be said that small-pox had been present in London at intervals since the beginning of the
year, but no case had been reported between March 17th and April 10th. J. D. sickened April
30th, and according to the usual experience with small-pox, he would have been infected some time
between 14th and 18th of that month, most probably on 16th Between April 10th and 23rd, cases
occurred in St. Pancras (1) and Marylebone (2), due to infection brought home by R.M.S.
Caledonia, and on April 20th a man, F. A., passed through London on his way from Moscow to
Stalybridge with the eruption of small-pox full out. This man is known to have given rise to
something like 40 or 50 cases in the North of England. In the absence of any clue from J. D.,
all attempts to trace the origin of his case, made by the medical officers of health of the various
districts in which the cases detailed occurred, proved futile.