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12
SANITARY CHRONICLES, 1895.
effectively isolated after death. Twenty of the subsequent
cases were all connected with this first fatal obscure case;
all of the twenty had visited the house.
In smallpox, there are two kinds of cases which spread
the disease; the one class is a very mild form, in which
the sufferer feels but slight inconvenience, has, perhaps, one
or two pimples, and does not seek any medical advice, but
pursues his ordinary avocation. The other class is that
in which the dose of the infection has been so large and
overpowering as by its very virulence to mask the usual
signs. Instances of the latter constantly occur in the
course of an epidemic, and when smallpox is actually in the
district are generally detected, for if among a series of
cases a person suddenly falls ill of some alarming illness,
the physician bears in mind the prevailing malady and the
sufferer is suspected of having contracted a malignant form
of it, but when, as in this instance, a local outbreak begins
by malignancy, it is no matter of surprise that, for a time, the
highest medical skill may be baffled in diagnosis. Therefore,
however unfortunate the result, blame seldom lies on
the medical attendant. Diseases are manifold in their
manifestations, and the short experience of one life is
insufficient to become acquainted with their varying phases.
The chart (opposite page), shows a curve, which is the
weekly register throughout the year of the number of cases
of smallpox notified. Arising in the first week of January,
it attained a maximum in the fourth week, and was
practically suppressed by the end of February.
"Suppressed" is the right word for taking advantage of
the facilities for removal by the Asylums Board: 101 out of
the 103 cases notified were removed to hospital within, at the
most, two hours from notification, some within an hour;
added to this the Vaccination Acts were put into force, and
disinfection was carried on as completely and as rapidly as
the imperfect appliances at the Stoneyard allowed, the
Guardians greatly assisting by giving their Vaccination
Officer directions suitable to the emergency; and probably
St. John's Wood, the chief scene of the outbreak, is, at the
present time, as well protected by vaccination from smallpox
as any part of London.