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12
to have examined. The Local Government Board issued
vaccine to the Medical Officer of Health for distribution
to the doctors for prophylactic and treatment purposes,
and notice was sent to all doctors residing in the district
of the availability of this method of dealing with cases. However,
only two doctors applied for vaccine, and subsequent enquiries
revealed that of these only one used it. No particulars of
the result could be obtained, as he was acting as a locum tenens
for a doctor who was ill, and left the district without leaving any
available records. I attribute the failure to make more use of
the vaccine to a natural hesitation in using a remedy which was
more or less in an experimental stage.
The only special feature of this particular outbreak was the
large number of cases in which Epistasis occurred as a symptom.
SMALLPOX.
I have to report that no further progress has been made in
pro\iding a hospital for the accommodation of cases of this
disease which may arise in Leyton. The scheme for a joint
hospital serving several districts in South-West Essex, mentioned
in last year's report, seems to have been shelved. Consequently
Leyton is still without any hospital to which cases of Smallpox
can be sent. I have drawn attention to this defect, which I
regard as a most serious one, year by year since I was first
appointed Medical Officer of Health, now some twelve years ago.
The following is a report I made to the Public Health
Committee on 9th April, 1918:—
Smallpox has lately appeared in the East End of London.
Stepney, Hackney and East Ham have reported cases. The
proximity of these cases to Leyton arouses great anxiety, as
Leyton has made no provision for hospital treatment of Smallpox.
We are entirely dependent on the goodwill of the Metropolitan
Asylums Board, who will certainly not admit our cases if
any pressure on their accommodation exists in London.
If vaccination and re-vaccination at intervals were universal,