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place. In view of this fact, there is a strong case for limiting the
number of those who should receive hospital isolation and care.
The considerations determining any limitations should be: (a) the
risks to other members of the family if the sufferer is not isolated
in hospital, when satisfactory home isolation is impossible;
(b) the state of the patient and severity of attack; (c) the industrial
and wage-earning circumstances of the family, and the possibility
of work being stopped or curtailed in respect of one or other member
of the family if the patient is nursed at home.
It looks as if it will be possible in the near future to protect
individuals from Scarlet Fever; and if the people will allow their
children to be so immunised, the result will be a considerable
reduction in the prevalence of the disease.
Return cases of Diphtheria and Scarlet Fever during the period
under review would be very few in number even if circumstantial
evidence were always accepted as establishing the fact that the
return of a patient from a Fever Hospital has led to the infection of
another member of the household.
SMALL-POX.
The possibility of the introduction of this disease to Stoke
Newington occasioned considerable anxiety during 1922-25, in view
of the number of centres of infection which established themselves
throughout England and Wales. Many false alarms had to be
investigated and many contacts kept under observation. I personally
undertook the re-vaccination of the Public Health Staff; and
other arrangements were made to enable all necessary measures
(including advice to the public with reference to vaccination and
re-vaccination) to be promptly taken, whenever the disease made its
appearance. Fortunately, no case occurred in Stoke Newington.
It is a fact that has been conclusively proved—and notably in
Germany—that Small-pox can be entirely abolished by vaccination
and re-vaccination of the population.