London's Pulse: Medical Officer of Health reports 1848-1972

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Islington 1860

[Report of the Medical Officer of Health for Islington, Parish of St Mary]

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Taking the entire number of cases in each Ward, the fatality of the disease was as follows, placing the Wards in the order of greatest fatality or virulence of theepidemic:—

Upper Holloway30 per cent. of cases were fatal.
St.Peter's20 ditto ditto
Canonbury18 ditto ditto
Thornhill16 ditto ditto
Lower Holloway11 ditto ditto
Barnsbury11 ditto ditto
St. Mary, HighburyNone fatal.

The measures which were taken to arrest the progress of the epidemic in this parish
may now be briefly recalled. Having placed myself in communication with the Board
of Trustees in the month of January, when the disease was assuming serious proportions,
I undertook to examine personally the children attending all the charitable
schools in the Parish, with a view to satisfying myself as to their vaccination. In this
work I was accompanied in each instance by one of the vaccinators of the district.
The Trustees also provided me with the necessary assistance for the delivery of handbills
in such localities as the information I received each morning pointed out as new
foci of infection. These handbills, and large posting bills also distributed over the
Parish, were designed to call public attention to the necessity of immediate vaccination,
and in certain instances of re-vaccination. And, lastly, another most valuable
and efficient assistant was provided me by the appointment of Dr. J. Thompson as a
Vaccine Inspector, to inquire into the vaccination of all uncertificated children born
within the previous year, with power to vaccinate when he thought it desirable—a
power which he exercised under certain restrictions, which, for professional reasons, I
thought fit to impose. The operation of all this was what was most to be desired.
The public generally were awakened to the presence of the pest among them, and to
the adoption of the best means to arrest its progress. Not only were the public vaccinations
greatly increased, but private practitioners, without exception, informed me
that the applications for vaccination made to them on the part of individuals and
families were also very numerous. Similar steps were taken in other Parishes. I
firmly believe that in this Parish the energetic measures adopted during the early
months of the year, and the stimulus given to protective vaccination must be regarded
as one of the main causes of the remarkable check which the epidemic received, and
especially of that diminution in virulence which (apart from the spread of the malady)
was noticed subsequently to March.
And now I am upon the. subject of vaccination, I should like to place on record my
conviction that the great sub-division of the public vaccination in this Parish is not
calculated to promote its efficiency, because it interposes difficulties which no considerations
of convenience to the poor can counterbalance. For such a Parish as this,
three, or at most four, well-chosen vaccine stations are as many as ought to be provided,
and at these the vaccination, except where there is immediate danger of small-pox, should
be performed only once or at most twice a-week. The difficulty to be met in this, that
in order to produce good pocks, and thoroughly to protect, the lymph should be taken
from selected children, and used fresh from arm to arm. In order to do this, the
district assigned to each vaccinator must be large enough, and the days of operation
limited enough to bring together on each day eight or ten children, at least, who had
been vaccinated eight days previously. From these the best arm could be selected