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53
The lodging houses were regularly visited by myself, the Chief
Sanitary Inspector, Inspectors Sanderson and Martinson, and
Dr. Wilkinson, both in the morning and late at night. Creat assistance
was also rendered by Mr. Albert Garner, the County Councilper cent.s Inspector
of Common Lodging Houses.
Type of the Disease and Mortality.—Although 301 persons in
Westminster suffered from small-pox, there were some who had it so
mildly that they were in no way inconvenienced, and continued going
about their usual avocations; others had it in a little worse form
(Discrete Type), but still a very modified type of the disease. There
were 231 cases in these two groups, with 8 deaths; 6 of the persons
who died were debilitated persons in the Infirmary suffering from other
complaints, and 2 were young children.
Fifty-one persons suffered from the disease in confluent form, a
more severe type, and 30 died.
Eighteen persons suffered from the hæmorrhagic form ("the blackpox"),
and all of them died. Nearly all these persons died in the early
stages of the disease before the usual eruption appeared, and there was
considerable difficulty in diagnosing the nature of the cases. In three of
the cases the haemorrhage into the pustules and Various organs of the
body came on at a later stage. It has been suggested that this type of
the disease results from the combined action of the small-pox organism
with that of septic organisms, which cause blood-poisoning.
Dividing the cases into groups according to their relation to vaccination,
it appears that 241 had been vaccinated more or less effectively
in childhood, but it must be kept in mind that some of these persons
had been very ineffectually vaccinated, and that therefore the degree of
protection afforded was much less than it ought to have been had
vaccination been properly performed. This is brought out in Tables
XX. and XXI., which shows the ages of vaccinated persons and the
number of marks.
The total death-rate was 18.6 per cent.; among the vaccinated, good
and bad, it was 10"7 per cent.; of the vaccinated who had .">, 4, or more
marks the death-rate was 6.6 per cent.; while those who had only
1 or 2 marks died at the rate of 19 7 per cent. The mortality of the
unvaccinated was (a) G4per cent.7 per cent.; (b) (vaccinated after infection),
40 per cent.; of those who stated they had been vaccinated, but showed
no signs of it, 42.8 per cent.; and of those with no statement, 50 per
cent. These figures, although calculated on a small number of cases, are
in accord with those derived from other outbreaks.
Table XX. shows the ages of small-pox patients, and it is instructive
to observe the ages of the various classes of patients, and the ages of
the fatal cases in their respective classes. Except two cases in badly