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9
The writer at once had an interview with the Salvation Army
authorities, and pressed upon them the immediate necessity
of closing the doors to all who were not protected by a recent
vaccination or a previous attack of smallpox, or who declined
there and then re-vaccination. This the authorities consented
to, and in a most businesslike way made suitable arrangements.
Night after night, the Public Vaccinator attended until a
late hour, and in a very short time the Salvation Army Shelter
was rendered practically immune, and as a fact the notification
of cases from the Shelter stopped. Instead of a source of
danger, it became a centre from which issued persons immune
to that particular contagium.
Mistakes in Diagnosis.—The number of cases of smallpox
given at the commencement of this account only
includes true cases of smallpox, there were a large number
of cases of mistaken diagnosis. Fortunately the Asylums
Board have an excellent system by which the patients do
not go at once to the Smallpox Hospitals, but are detained
a short time at a sort of observation station from whence
true cases are removed, doubtful cases detained for development,
and obvious errors rectified by promptly returning
cases to their homes. If the Public should insist that in
every case an accurate diagnosis be made at the bedside
the results from a preventive point of view would be unfortunate,
for should the case turn out to be infectious, the longer
unisolated the more likely the spread. The first symptoms
of all eruptive fevers are similar, the first stage of most eruptions
not typical, hence errors are bound to be made even by the
most experienced. It is only justice to further state that
in not a few of the so-called errors in diagnosis, the medical
men were in doubt, and it was from a consideration of the
dangers of infection spreading, that they resolved to certify
"smallpox." It is satisfactory to learn that in none of the
cases of erroneous diagnosis did any harm result.
Vaccination.—The Borough was not adequately protected,
even by primary vaccination, from smallpox, still less
was there any large section of the community protected by
re-vaccination. The best protected quarter in this respect
was St. John's Wood, because of the former sharp outbreak
in the year, and it is noticeable that St. John's Wood
suffered during 1901-2 in only a trifling degree.
The number of primary vaccinations in the Borough from
October, 1901 to January, 1902, was, according to a return
given to me by Mr. Frith, the Vaccination Officer, as follows:—