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So that, from the statistics of these cases, it would appear that vaccination
reduced the liability to the occurrence of Small Pox to one-eighth of what
it would have been without vaccination, and reduced the mortality amongst
the persons actually attacked from 28 in a 100 to less than 2 in 100.*
The advantage to be derived from re-vaccination, when judiciously practised,
was shewn at the Orphan Working School, where several children were
suddenly attacked with Small Pox; all the children were carefully examined
by Mr. Harris, the Surgeon of that establishment, and those who were thought
to need it were re-vaccinated; there was not a single case of the disease after
this precaution had been adopted.
No case came to my knowledge of any permanently bad results accruing from
re-vaccination in this parish, but many cases were reported, in which the spread
of the disease was arrested by this means. This operation is not one which
should be indiscriminately and universally recommended, but in epidemic
seasons, such as occurred last year, or when persons are strongly exposed to
infection, there is indisputable proof that, if adopted with discretion, it is of
great value, especially where the marks of the first vaccination are not
satisfactory, and the person exposed to infection is above the age of from 7 to
10 years.
The cases of Small Pox congregated in the separation wards of the Workhouse
led to the spread of the disease, to a small extent only, amongst the inmates of
other parts of the house; its extension would probably have been greater, if
Dr. Saul had not exercised great vigilance in keeping these wards as distinct as
possible, and in re-vaccinating a number of the inmates.
There was a remarkable outbreak of the disease in that part of Agar Town
which immediately adjoined the Small Pox Wards. Within a few days at the
beginning of May, 19 cases of Small Pox occurred in Cambridge Eow, Cambridge
Crescent, and Cambridge Street. Before that date, not a single case of
Small Pox had been heard of in these streets. The distance from the Small
Pox Wards to the houses attacked was very small; four cases were within 50
feet, 6 within 100 feet, and 8 within 200 feet; there was no communication
between them, as no patients or persons in attendance passed in or out of the
Workhouse on that side. Such a sudden and extensive outbreak cannot be
ascribed to one or two imported cases from other parts, because this disease
always lies dormant in the system 12 or 14 days after exposure to infection;
we can only therefore believe that the emanations from the Small Pox Wards
were carried by the wind into these houses, and that those inhabitants who
were in a susceptible condition contracted the disease. These streets are situated
east and south-east of the Small Pox Wards; and it is remarkable that the
prevailing winds during the week when these cases must have been contracted,
were from the north-west and west. The history of this outbreak is very
interesting in connexion with the spread of epidemic diseases, showing that
infection can, when concentrated, be conveyed by the atmosphere for a considerable
distance. The commonest modes of conveyance are no doubt from
person to person, and by means of clothes.
The deaths from Measles were 132 in number ; from Scarlatina, 380 ; from
Hooping Cough, 176; from Typhus, Typhoid, and Eemittent Fevers, 119, from
Diphtheria, 74; from Croup, 40; Erysipelas, 36; from Puerperal Fever, 14;
* There were two children who were exposed to Small Pox at birth, and vaccinated a few days
later, who died. These are counted as unprotected cases.