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man had been drinking in the "Frying Pan" public house at a time when he must have been infectious.
The same day several other cases were removed, one from Victoria Home, Commercial-street, three
who had been staying in the lodging house in Brick-lane, one of whom was a newsvendor at Liverpoolstreet
Station, and another, a vanboy. Three other seamen's or common lodging houses also became
invaded during the month of March, one in Tooley-street, one in Dock-street and one in Wentworthstreet,
Whitecliapel.
Smallpox had therefore made considerable progress in the common lodging house and
seamen's lodging house population of Poplar and Stepney during March. During the same
month smallpox spread rapidly in Bethnal Green, due in the main to infection from a man
named H., employed as a bricklayer, who died in some model dwellings on the 23rd February in Corfieldstreet,
of an illness which there is no reason for doubting was hemorrhagic smallpox, although the nature
of his malady was not recognised during his lifetime. On the 4th March, Dr. Bate, the medical officer
of Bethnal Green, found this man's wife, a baby and two sons, suffering from smallpox. Dr. Bate
reports that the coffin of this man was opened at the time of the funeral and his mother and several
other members of the family who came from Braintrec to attend the funeral subsequently developed
smallpox, together with three other persons, two of whom were daughters of a woman who had assisted
in nursing the first case H. Dr. Bate then investigated the illness of three families residing in the same
block of buildings and who had been suffering from a pustular rash which had been thought to be that
of chickenpox. Of these cases, Dr. Bate states, that he feels certain that the children had suffered
from mild smallpox. Other cases occurred in the buildings and remote from them, including an employe
of the undertaker who buried H. Moreover, during March cases of smallpox occurred among the inpatients
of the London Hospital, due to infection from a patient suffering from smallpox, but whose
malady had been thought to be chicken-pox. To what extent this man's illness was responsible for
subsequent cases cannot be stated, but after his discharge from hospital a sanitary inspector of Bethnal
Green found him wheeling a barrow while he was still in an infectious state. His children were then
found to be suffering from smallpox, which had been thought to be chickenpox and his landlady was also
subsequently attacked and removed to the Smallpox Hospital, as well as his brother, a resident of
Stepney, who visited him in the London Hospital. Thus Bethnal Green, Stepney and Poplar were
most severely attacked in March, the number of cases of smallpox removed to hospital during that
month being respectively 40, 35 and 22 in those districts out of 131 in the total area of London.
At this period one of the outbreak, with a view to the better control of smallpox, the Borough
Council of Bethnal Green made an order requiring the notification of chickenpox in the borough;
this order came into operation on the 26th March. The County Council made a like order requiring
the notification of chickenpox throughout London, which come into operation on the 8th April
Chickenpox was thus required to be notified in London until the 7th November. Moreover the
County Council appointed as from the 1st April, Drs. Bingham and Wanklyn to visit at the request
of any medical practitioner, any doubtful case of smallpox and continued their services for this
purpose the former until the 7th August and the latter until the 7th November.
In April, the number of cases of smallpox showed some diminution, 91 persons suffering from
tliis disease being admitted into the smallpox hospital. These cases were widely distributed over London,
but the main incidence was on the Eastern districts. Of these cases, ten were inmates of common
lodging houses who were removed, two from Thrawl-street, one from Brick-lane, two from Tooleystreet,
one from Essex-road, Islington, one from West India Dock-road, Stepney, one from Eagle Wharf
road, Shoreditch, and two from Kingsland-road, Shoreditch. Two cases were also removed from the
Sailors' Home in Dock-street. In May there was still further decline, 83 persons being removed from
London to the smallpox hospital, 36 of whom were residents in Bethnal Green. The greatest number
of cases removed from any other district was eight from the Borough of Southwark. The spread of
smallpox among the inmates of common lodging houses and seamen's lodging houses was by this time
nearly at an end, but three cases were removed from the common lodging house in Tooley-street,
Bermondsey, and one from the common lodging house in Kingsland-road, Shoreditch, both of which
had been infected in the preceding month. From the common lodging house in Tooley-street six cases
of smallpox in all were removed during the months of March, April and May. Dr. Brown, the medical
officer of health of Bermondsey, states in his annual report in reference to this house that " The London
County Council kept a very close watch on the Southwark-chambers which are capable of accommodating
upwards of 500 lodgers. The average number of lodgers on the night previous to the notification of the
various cases was 395 ; of these 349 were vaccinated and none of them showed any symptom of smallpox.
The premises were visited every morning by the special inspector of the London County Council,
and during the day by our inspector and all suspicious cases were immediately sent to bed and isolated
till one of the London County Council smallpox experts pronounced an opinion on them."
In subsequent months of the year the number of cases occurring was markedly less; the number
of cases removed to hospital being in June, 45, July, 31, August, 1, September, 3, October, 0,
November 1, and December, 15. Of those occurring in December, 9 were removed from Deptford and 5
from Woolwich.—Dr. Roberts, the medical officer of health of Deptford, states that in the latter part
of November and in early December, four cases were removed from a house in New Cross-road, viz.,
one adult, vaccinated in infancy, and three unvaccinated children, and later in December, two adults
and three unvaccinated children from a house in Tanners-hill, the latter household having received
infection from the former. The Woolwich cases were a series beginning with the attack of a man
the nature of whose illness was not discovered until he had infected three neighbours, the fifth case
being a sister of one of the latter who had visited the sick room after removal of the patient, but
before the room was disinfected.