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Taking into consideration the special facilities in such dwellings for the
spread of Small-pox, from the use in common of staircases, playground,
wash-houses, &c., your Medical Officer urged the necessity of vaccination,
and it was resolved that in future no persons should be accepted as tenants
who were not protected by efficient vaccination and re-vaccination.
A system of daily notification of all cases of Small-pox within the Metropolitan
area, and the names, addresses, and occupation of all "contacts" was
organised by the Incorporated Society of Medical Officers of Health, and has
been found of great value.
A very large number of such "contacts" are employed in the City, which
is therefore exposed to danger of infection to a far greater extent than exists
in any other district in the County of London.
This naturally entails an enormous amount of work in visiting such persons,
urging upon their employers the necessity for protecting their whole staff, and
in forwarding the lists of those willing to submit, to the Vaccination Officer.
For this purpose the services of a special temporary Inspector were
engaged, and, in consequence, by the end of the year 5,848 persons had
been re-vaccinated by the Public Vaccinators, in addition to the large
numbers operated upon by private practitioners.
So far there have been but few cases of Small-pox actually occurring within
the City, vide pp. 17 et seq.
TUBERCULOSIS.
The subject of Tuberculosis has of late years been prominently before the
public, and attention has been called to the preventive measures practicable by
the community to an extent that must in the near future bring about a
considerable and increasing diminution in the terrible toll that this disease
still exacts.
The direction which must be taken is that of using all means in our power
to bring home to the people that the question is, in the main, one for them,
and that whatever legislation may be able to effect, and whatever Health
Authorities may carry out, the real measures of prevention are those which
should be effected in our homes and in our habits.
To in some measure place this before the public, the British Conference on
Consumption was held in London in July, to which Mr. Alderman Crosby, M.D.,
and your Medical Officer were appointed as delegates by the Corporation. So
valuable and practical were the proceedings, that it seems desirable to report
briefly thereon, dealing only with the principal divisions of the subject.
Heredity.—It was clearly shown by all who read papers that the influence
of heredity may absolutely be ignored as the chief factor in the causation of