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March—A boy, stepson of, and living in Poplar with the patient attacked in February,
and associated with the Hackney group; a man in Hackney, who worked with a member of
the Hackney group; the wife of the last case.
April—A clerk, aged 23 years, in St. Pancras, who had been employed on board s.s.
Caledonia, which two days after leaving Bombay had two cases among the crew; the brother
and the mother of the clerk, living with him; a charwoman, also living in St. Pancras, who
worked for her; a steward, living in block dwellings, in Marylebone, employed on board
the same vessel; the wife of the last patient; a woman, living in the block dwellings,
Marylebone, who visited the steward's wife.
May—A man, who occupied rooms in the block dwellings, in Marylebone, adjoining
those of the ship's steward. The wife of a valet in Chelsea, whose husband had died just
before from hemorrhagic but unrecognised small-pox;* she was removed to the St. George's
infirmary, where an attendant was attacked; a girl in Kensington, where her step-grandmother,
the valet's wife, had been staying for two nights after discharge from the infirmary;
a boy in Marylebone, who was the son of the man employed by the vestry in the removal of
infected bedding; a woman in Mile-end Old-town, who fell ill the day she arrived from
Hamburg.†
June—A child in Kensington, sister of the child who had been with the valet's wife.
Two in-patients, a nurse, a ward maid and a student in St. Mary's hospital, Paddington (a
female patient who had resided immediately over the flat in Chelsea in which the valet and
his wife had lived had been previously admitted to St. Mary's hospital, where she died of
unrecognised hoemorrhagic small-pox). The valet's linen had been sent to a laundry at
Chiswick, and during the month of J une six cases of small-pox were notified in Kensington
and Fulham, all having origin in infection received directly or indirectly from this
source, the persons attacked being either workers or relatives of workers at this laundry. ‡
A boy in St. George-in-the-East, who was thought by his mother to have contracted the
disease from an infant in the house, whose illness, however, had not been notified as
small-pox; the boy was removed to the infirmary, where he infected three members of
the staff and two patients. A man on board a vessel in the Port of London; a boy who
sickened in Bethnal-green a day or two after landing from a ship from Russia.
July—Two cases in Fulham and two in Hammersmith, belonging to the Chiswick
laundry group. A woman living in the house where the boy, who gave rise to the: cases
in St. George-in-the-East Infirmary, went to school; between the boy's attack and the
woman's, the schoolmaster's son had measles with a few dark spots on the face during
convalescence; a man in Wandsworth, source of infection unknown; a woman in
Bethnal-green, source of infection not known.
August—A boy and girl in Wandsworth. Their brother had come home from sea
suffering from what had been called chicken-pox; his father died from " heart disease,"
but had a rash.
September—A woman in Wandsworth, who visited the boy and girl.
November—A resident in a house in Chelsea suffered from what was called blood
poisoning two days after his return from Paris. His illness was followed by attack by
small-pox of two of his servants—the one notified in Chelsea, the other in Fulham.
Dr. Collingridge, the medical officer of health of the Port of London, gives account of
eight vessels arriving in the port, cases of small-pox having occurred on board. In six instances
these vessels had come from Bombay.
It is well deserving of note that much of the small-pox in London in 1900 had its origin
in infection received abroad. The first case of the group of eighteen cases, occurring mostly in
Hackney, was that of a boy living in proximity to the Eastern Hospital, the date of whose attack
appears to coincide in point of time with those of patients in the Eastern Hospital who had been
infected by a man in the Eastern Hospital who was admitted on the 7th December, and was
removed, suffering from small-pox, on the 9th December, 1899. This man had returned from
Jerusalem suffering from small-pox. If this explanation of the boy's illness be correct, some
twenty-five cases (eighteen in 1900) had their origin in this source. If Dr. Ricketts' view that
the illness of the Chelsea valet was due to infection from one of the s.s. Caledonia cases, there
are twenty-nine cases (probably thirty-one) again having their origin in infection received from
abroad. To these must be added a group of three or four cases probably due to infection from a
boy infected abroad; also two servants infected by their master, who had no doubt contracted
small-pox in Paris. There were also a few other cases in which infection had been
received abroad, but not giving rise to a series of cases.
Of the cases admitted into the hospital ships, sixty-seven in all, the report of the Statistical
Committee of the Metropolitan Asylums Board shows that in forty-nine cases vaccination cicatrices
were present; in thirteen cases they were absent, and in three there was "no evidence." Of
these patients three died, one having vaccination cicatrices and two having none.
* Dr. Ricketts, medical superintendent of the small-pox hospital ships, in a report to the Metropolitan
Asylums Board, states "the origin of his illness was for long obscure, but it appears probable that he caught
small-pox at an eating-house in the north of London, from one of the cases originating in the Caledonia.
† Dr. Dudfield also states that the funeral of the valet was attended by his son from a Midland town
on 12th May, who was taken ill on the 25th with what was thought to be eczema. His child was taken ill on
8th June, and his servant on 9th June. The latter's illness was recognised as small-pox, and this led to
correct diagnosis of the earlier cases. The man sickened on the 13th, and died of hemorrhagic small-pox.
‡ Dr. Reginald Dudfield in his annual report mentions two other persons residing in Kensal-town but
working at this laundry who suffered from a disease which at the time had been regarded as chicken-pox.