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patient suffering from modified small-pox, i.e., small-pox occurring
in a person who at a previous period of life had been successfully
vanccinated a disease often of singular mildness, and then, not
compelling the patient's confinement to the house. In April
another death from small pox occurred, and the facts that came out
in the enquiry to which it gave occasion are so instructive as to
bear repetition in this place. The deceased and her only child, a
girl of four years, contracted the disease from her husband, the history
of whose illness is briefly as follows:—
On or about Tuesday, the 14th March, he was taken ill in the
street, got home with some difficulty, and for a few days afterwards
was confined to the house, though still able to take part in carrying
on his business. On Friday, the 17th, an eruption made its appearance
on his face, which he suspected to be of the nature of
small-pox from having seen cases of the disease during the last
epidemic. His suspicions, however, were set at rest by an authoritative
assurance that the eruption was of a simple and innocent
character. He therefore not only continued to attend to his business,
but on Tuesday, the 21st March (fifth day of the eruption),
he resumed out-door exercise. No precautions were taken to prevent
the spread of the disease, for none appeared necessary, and the unprotected
wife and child were thus exposed to the full force of the
contagion. The wife fell ill, but not until Sunday, the 2nd April,
and again the gravity of the case appears to have been overlooked:
the eruption of small-pox appeared on Wednesday, the 5th April,
and was recognised on the following day. Arrangements were then
made for the patient's removal to the London small-pox hospital at
Highgate, which, however, was not effected till Sunday, the 9th,
and the poor woman died on the 11th. The child fell ill on Thursday,
the 6th April, the eruption made its appearance on the
8th, and she recovered, after a very severe and dangerous attack of
confluent small-pox. She had been vaccinated only two days
before her illness, viz., on the day that the nature of her mother's
illness was recognised, but all too late to do her any good, for the
vaccination and the small-pox alike ran their accustomed course side
by side without the one in any way influencing the other. Vaccination
in infancy had been neglected in deference to the mother's
prejudices. The mother herself had been imperfectly vaccinated in
childhood. The failure in medical diagnosis in the first of these
cases is much to be regretted, for the dates prove that if the disease
had been recognised even when the eruption appeared on the
husband, his immediate isolation would have saved the wife and
child, and they might at that time have been protected by
vaccination.
Whilst investigating the above cases, another case in the same
street came to my knowledge, the circumstances of which are
no less remarkable. The patient was a young man, an assistant in
a shop. The eruption of small-pox came out on Sunday, the 16th
January, but the constitutional disturbance was so slight as not to
hinder him, for a day, from following his occupation. On Friday,