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77
(d) Smallpox.—There have been 45 cases of smallpox during
the year 1930. Not one case proved fatal, but one case was of
a very severe order and left permanent injury to one eye of the
patient. This case is interesting by reason of the fact no contact
could be proved with any similar serious case, in which circumstance
we have once more evidence for believing that the serious
type of smallpox and the lesser types of smallpox are all one, the
only real difference between modern epidemics and epidemics of
olden days being that, whereas in olden days a relatively small
number of cases were mild and the majority of cases were severe,
at the present time the larger number of cases are mild and only
a few cases are severe.
The system of persons being admitted to an hospital from
which they can be and are discharged without even a consultation
with the Medical Officer is bad.
One case stands out in my memory during the past year of a
man in whom the signs were, and were known to be, equivocable.
Every consideration was given to the question, and the diagnosis
rested to a certain extent not only on the actual physical signs but
also on the epidemicological evidence.
This man was admitted one day, we got in touch with the
hospital and fouNd that they too confirmed the signs and they, with
us, thought they were very suggestive, and then on the fourth day
the man was discharged without even a consultation.
Of course, it is quite possible that your Medical Officer would
have changed his mind if he similarly had had an opportunity of
observing the case in hospital for four days, but on the other hand,
the question was one of such difficulty and one in which a personal
opinion is likely to vary, that it does seem unfortunate that a
Medical Officer should have returned to his area a patient who may
after all, so far as he knows, very well be suffering from smallpox.
The County Medical Officer still continues to duplicate the
circulars we send out to neighbouring authorities with reference to
cases of smallpox which occur in Barking.
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