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Note.—The vaccinated include all cases that had any evidence of vaccination, however imperfect.
A further conclusive proof of the life-saving power of vaccination is the great change in the
age incidence of the disease. Before vaccination was introduced, the number of deaths of children
under ten years of age was enormous, and greater than the total number of deaths of persons of all
other ages. Now the deaths of children under ten years of age is but a small percentage of the total
deaths from small-pox, and practically include only children that had not been vaccinated.
(2) Early Diagnosis of the Disease.
The early diagnosis of the disease is of great importance, as if the patient is removed to Hospital
the first day of the rash, and all contacts at once re-vaccinated and disinfection carried out, the disease
will not spread.
It is well known that there is great difficulty in the diagnosis of many cases of Small-pox.
I was asked by Medical Practitioners to see very many cases of Small-pox, Chicken-pox and
suspicious cases before the notifications were made.
The Council adopted the notification of Chicken-pox, and one of the early cases notified, I found
on examination, was a case of Small-pox.
The Metropolitan Asylum Board kindly made arrangements for Metropolitan Medical Officers
of Health to visit the South Wharf and Small-pox Ships. I gladly availed myself of the opportunity.
Arrangements ought to be made for all medical students to see cases of Small-pox.
(3) Prompt Removal of the Patient to Hospital.
This service is admirably carried out by the Metropolitan Asylums Board. On receipt of a
message by telephone or telegram, an ambulance with a driver, porter and nurse is at once despatched
at any time during the day or night.
I was generally on duty long after office hours; and at the beginning of the present year the
Public Health Committee consented to an Inspector being on duty till 10 p.m., and on Sundays till
1 P.m., and Dr. Watkins-Pitchford was appointed to assist me. He was on duty after office hours,
and he and I took Sunday duty alternately.
(4) Disinfection.
All infected rooms and articles were thoroughly disinfected, all bedding, clothing, linen, etc.,
being removed from the house and disinfected in the Council's steam disinfector. Additional men
were furnished by the Borough Surveyor as the outbreak increased. Shafts were added to the
disinfecting trucks, and a pony was employed to draw them.