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the only person who ultimately recovered in the same house out of
five who were attacked had been taken ill a month previously, in
fact, before the middle of August. From this house the infection
no doubt spread, but as some of the earlier cases were traceable to
other sources of infection, and as it has since been rumoured that
mild cases had occurred in the neighbourhood at an earlier date
than that referred to, there is no need to indulge in any fanciful
supposition as to its having arisen in any other way than by direct
contagion ; moreover, the disease was already epidemic in South
London.
2. As to the Spread of the Disease.
Many causes contribute to the intensity of an outbreak of
Small-pox, and to its rapid spread. The neglect of vaccination, or
its inefficient performance, and especially the neglect of re-vaccination,
is the first and the most prominent cause that occurs to me. The
immensity of harm done by a few noisy agitators is perfectly
appalling. The detailed statistics of our own parish, that I have
laid before you in this Report ; even yet more, the statistics, not of
this Parish alone, but of all London; and lastly, most important of
all, the facts noted and tabulated by the Officers of the Metropolitan
Asylums Board —each and all must carry with them absolute conviction
on this point to those who are willing to be convinced. I
will not enlarge on this point further. Again, the concealment of
many cases of disease from the Sanitary Authority, and their consequent
non-removal to the Hospital is a very serious evil. The
history of many a case is something of this kind. A man has a
slight attack of the disease. He may be ignorant of its nature or
not, but at any rate he says nothing about it. He goes to his work
in the morning as usual, to mix with his brother workmen, and returns
home at night to mix with a house full of children and fellow
lodgers. To go to the Hospital, or to stop at home, means " loss of
pay." Rather than this, he prefers to sow the seeds of the disease
at the workshop and at his home, spreading broadcast the poison
which in his case, perhaps, has only produced very slight effects,
but which, nevertheless, in other constitutions may work with
terrible and even deadly results. Or, again a child has a modified