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hæmorrhagic or "black" variety of the disease, and terminated fatally. No
secondary cases in the infirmary or elsewhere were traced to this case. The next
case was on February 12th. -A man aged 59 was picked up in the street by the police
and taken to the police station, whence he was removed to the infirmary, where he
was found to have small-pox and forthwith removed to hospital. There were no
secondary cases traceable to this one. The third case was that of a man aged 58. He
had been an inmate on and off for some considerable time. He was taken ill on
February 14th, and removed to hospital on February 16th, and probably contracted
the disease whilst visiting friends in the neighbourhood of Nile Street. On February
21st a fourth case came under observation, that of a man aged 35, who had been an
inmate since January 13th. It is not known how he became infected. The fifth case
was removed on March 2nd, the patient being a woman aged 33, and an inmate of the
workhouse for some time. Whilst visiting friends at No. 4, Wellington Place, she
came into contact with a case of small-pox, which was doubtless the source of infection
in her case. From March 7th to 9th two of the inmates in the infirmary and one in
the workhouse were found to be suffering from small-pox. These cases probably
resulted through infection from a previous case in the institution. Although a
considerable number of persons must have been exposed to infection from these three
cases, no one in the institution contracted small pox from them. On April 15th a girl
aged seven, who had recently been sent to a branch school in London from the schools
at Hornchurch, in Essex, belonging to the Guardians of Shoreditch, was taken ill and
removed to the Shoreditch Infirmary, where she was found to be suffering from a mild
attack of small-pox. Two days later another girl, aged 13, recently come from the
schools at Hornchurch, was found to have the disease. These children were infected
before coming to London. The last case in the institution was in May; an infant was
received whilst incubating the disease and developed it shortly after admission.
The measures for preventing the spread of the dispase taken by the medical
officer, Dr. E. Norton, included the disinfection of the bedsteads and the floors and
woolwork in the vicinity where the small-pox patients had been lying, and the free
ventilation of the wards in which the cases had occurred. The bedding, clothing and
textile articles which had been exposed to infection were removed and disinfected at
the Borough disinfecting station. All persons who had been in contact with or in
the same wards as the patients were kept under observation until the peril d of
incubation of the disease was past. Isolation wards were set apart for suspected cases.
All persons who had been or were likely to have been exposed to infection, and who
raised no objection, were vaccinated or re-vaccinated. The number of persons thus
vaccinated or re vaccinated in the institution was 282. So far as is known the number
of persons who were infected within the workhouse and infirmary was limited to three,
a result which speaks well for the efficiency of the measures adopted to prevent the
spread of infection.
In the Holborn Workhouse the cases were more numerous. On November 4th
1901, two eases referred, to in my Annual Report for that year were, through an error,
sent to the workhouse from Holborn. They were at once recognized to be small-pox,