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parents professed themselves unable to account for his illness, but
it transpired that their married danghter, who lived two doors off,
had been ill as well as her child (who died), and that there had
been constant intercourse between the two families throughout the
illness in the latter. The only other case I shall allude to (I did
not trace the origin of it) was that of Mr. J., whose mother kept a
laundry, the business of which was carried on without interruption
during the man's illness, which was concealed as usual.
This history I think proves that the disinfecting chamber had
nothing to do with the origin or with the spread of the disease, but
the belief was general and invincible in the neighbourhood that it
was the sole cause. There can, however, be no reasonable doubt that
the malady spread by direct contact—because the sick were retained
in crowded houses, without the possibility of isolation or the requisites
for safe treatment: because, moreover, the people seemingly
took no precaution to prevent its spreading; and rarely, unless compelled,
disinfected their rooms, clothing, &c. In my last annual
report I dwelt on the fact that the speedy removal of a first
case, always prevented the spread of disease in the same house,
and often in the locality also We could not say how the disease
got entrance, but we could and did stop it, but where cases were
concealed, or if the patients were not removed, the disease spread
and lingered till it had exhausted itself. Another fact of great
importance came out in the course of the enquiry, viz., the inadequate
medical attendance received by the sick. The people would
not go to the District Medical Officer because they knew he would,
as in duty bound, urge the removal of the sick; and as a rule they
did not go to a private practitioner, because they could not afford
to pay him for his services. In several fatal and other cases 1
ascertained that a medical man had been called in but once, apparently
to give a diagnosis, and possibly to prevent difficulties in the
event of a fatal termination, so that there was practically no
medical treatment. When I visited Mrs. A. she had not been seen
by a medical man for eight days. Mrs. B. sought advice at the
last gasp for the child who died, but for no other member of her
family. In a few instances the bodies of persons who died of
small-pox were buried without medical certificates In other instances
certificates were given though there had been no legitimate
medical attendance, the doctor not having been called in until
death was imminent. Most of the victims were, of course, unvaccinated.
At an early period of the epidemic I tried without success
to obtain inquests upon uuvaccinated children, who died
of small-pox and I still believe that such enquiries at
that time would have been useful. I hold, moreover, that
inquests should be held when persons die of a malady like
small-pox, without medical attendance and particularly when
the disease might possibly have been prevented by proper measures
of precaution. It is said that the object of the coroner's inquisition