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23
dealing energetically with a first case of illness. They hope there
will not be a second, and they often say if there should be, the
patient shall go to the hospital. Often the father will send his
child, but will not go himself. Vaccination again is hot seldom
railed against till small-pox appears, and then when the mischief
has begun, and perhaps cannot be stopped, the people rush to the
public vaccinator. Through schools the disease may be spread,
for as no law forbids the exposure of infected things on the body
of uninfected persons (so we are advised); children may go to school
in garments reeking with infection ; and unless attention is called
to the possibilty of sickness in the house by the absence of a pupil,
the school-officer has no warning of the risk to which the
entire establishment is exposed. It is no uncommon thing I fear
for infected clothes to be sent to the wash without previous effectual
disinfection, and it is a common practice to hang out infected
clothing, bedding, &c., in the back yards, called by courtesy
gardens, and thus the winds are made to diffuse disease in every
direction. In all these ways we know the malady has been spread;
and indeed, considering the facilities for the diffusion of infection,
and our limited powers to check it, the marvel is not that we have
had so much, but that we have had so little small pox in our
midst. On the whole our efforts for effecting the removal of the
sick have been more successful during the present epidemic than
in that which raged in 1871-2, and the deaths 'at home' have consequently
been fewer. Thus in 1871 there were 62 deaths 'at home'
and 58 in the hospitals : and in 1872 the deaths 'at home' and in
hospital were 39 and 29 respectively, whereas in the 12 months
ended July 31st, 1877, the deaths at home were only 25, and those
in the hospitals 44. It must be confessed, however, that the
present epidemic has not attained the proportions of the former one,
for while our highest monthly record of cases in 1871-2 was 116,
the largest monthly total during the present epidemic has been 50
only. Estimating the mortality at 20 per cent. on the attacks, the
cases kept at home would be 125, our record to the end of July
giving 108, thus showing a smaller number of concealed or
unknown cases than in 1871, when we heard of 164 cases only,
out of an estimated total of 310.
Following the custom of former reports, I now proceed to mention
a few local outbreaks of the disease which were traced
to their origin; for information of this kind tends to destroy the
fatalistic belief that as infection is "in the air," it is useless to
try to prevent the spread of disease. The first group of cases I
shall mention commenced—at any rate our knowledge of it began
in the kitchen of Denbigh Villa, in Denbigh Terrace. The
primary case was that of a man aged 52 years, of whose illness we
heard nothing till the case was approaching a fatal termination,