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the 21st, annoyed at his disfigurement, he sought advice, and was
assured of the innocency of the eruption. He therefore continued in
his employment till Sunday, the 23rd, when the nature of the
disease was recognized, and the man was sent home to bed, and
made a speedy recovery. I may mention that this man and the
other before mentioned, who when seen still bore the traces of their
illness on their faces in the form of "pitting," were quite ignorant
how or where they contracted the disease. Their cases afford
a good practical illustration of the view expressed above, that
the first fatal case alluded to may have been contracted from a person
suffering from modified small-pox, for it must be obvious that these
men were capable of spreading the disease to any extent among
susceptible individuals. They both had been efficiently vaccinated
in infancy. Could we desire any better evidence of the protective
power of vaccination than is afforded by this contrast? Three
unvaccinated persons suffer from confluent small-pox, and two of
them die; while the two patients who had been vaccinated take
the disease so mildly as not to be prevented from attending to their
business. At the end of June four other cases of small-pox occurred.
The previous cases were all at Notting Hill: these, south of
Kensington high road. Two of the patients, domestic servants in
place, and the third, a married woman, were removed to the smallpox
hospital at Stockwell, through the agency of the relieving
officer; the fourth case, a single man, was properly isolated and
treated at his own residence. No connecting link between these
cases could be traced, though they all occurred within the course
of a few days, but at considerable distance apart. There are not
wanting signs that small-pox is about to visit this Metropolis again,
and it is to be regretted, therefore, that in the absence of a registration
of diseases, and of what is still more urgently needed, a
legislative enactment for the compulsory disclosure of infectious
maladies, we have no certain means of ascertaining the existence of
even so dangerous a disease, unless cases occur in dispensary or
poor-law practice; and even then we are indebted to the courtesy
of the officials for any information we may receive. It was by
the merest accident that I heard of the first-mentioned group of
cases.
Scarlet fever was not prevalent beyond the average, the deaths
having been 83, against an uncorrected average in ten years of
73. After making due allowance for increase of population, the
deaths in 1876 at the decennial rate would have been 91. The
deaths from diphtheria were nine above the average. This disease
appears to be on the increase, unless we assume that in
former days some cases were returned as scarlet fever, as was
the fact prior to 1869 when diphtheria was first separately registered.
Diphtheria, Scarlet-fever, and Measles were prevalent diseases
for a short time at the end of the year in Brompton, but they did
not lay any serious hold on the district. There were six deaths
from measles and diphtheria respectively, and two from scarlet+