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8
Some particulars were given in my last report With respect to
the cases that had occurred from the beginning of the epidemic
down to the end of September, 1877. Since that date and to the
end of June, 1878, viz., in nine months 198 eases have been reported,
of which 58 occurred in the district north of the Uxbridge
Road, and 140 in the district south thereof, the majority of the
latter in the south-west part of the parish, in the Brompton
Poor Law District: 147 of the sufferers were over, and 51
under 15 years of age. The cases recorded in the whole year,
1877, were 359 (240 north, and 119 south of Uxbridge Road).
They occurred in 271 houses in 213 streets. Two hundred and
fifty-five of the cases were removed to hospitals, and 104 were
kept at home. The deaths in the hospitals were 60, and the
deaths registered in the parish 24.* The rate of mortality in
hospital and home treated cases, so far as known to us, was about
the same.
It is probable that some carefully concealed cases may not have
come to our knowledge; and, in this event, the per centage of fatal
cases would show higher at the hospital than ' at home.' But then
it is notorious that many of the cases that are treated at home, are
very light, while the gravity of other cases determines in the
minds of parents and relatives the necessity for removal to the
hospital. I need hardly say that the inspectors are instructed to
press for the removal of all cases, and especially of light cases,
for these are truly the most dangerous when kept at home, it being
found difficult to induce the "sick" person to keep his room, and
separate himself from the rest of the world, when he may be unconscious
of anything being wrong with him, so far as he can judge
by his own sensations, and especially in those instances when the
rash is small in amount and more than usually modified and brief
in its duration, as a result of previous vaccination. A large, and
speaking generally, an increasingly large proportion of the cases
have been sent to the hospitals, the popular objection to which,
so far as this particular disease is concerned, would appear to be
on the wane. Certain it is that the Inspectors do not often experience
serious difficulty in getting patients removed, and but
rarely meet with an absolute refusal. The cases which, as a rule,
are treated at home, are cases that have been concealed, or cases
in private houses having such good accommodation as to render
removal unnecessary. In some cases that come within the latter
class, however, removal to a hospital—the London Small Pox
Hospital generally—has been desired by the patient.
There has always been a marked difference in the classes of
cases in the two great divisions of the parish, north and south
of the Uxbridge Road. In the north children have formed a
*The names of the streets where fatal cases occurred in Kensington are given in
Table 9 (Appendix).