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14
months. Of these 121 cases, 20 occurred North and 101 South of the
Uxbridge Road: 21 were under, and 100 were over, 15 years of age;
92 of the sufferers were removed to Hospitals and 29 were treated at
home. The disease made its appearance in 93 streets and in 108
houses. The deaths in the registration year 1878 were 24, viz., 8 at the
homes of the sick (3 in the Town sub-district and 5 in Brompton)
and 16 at the Hospitals. During the present epidemic, as in the
previous one in 1871-2, which was of shorter duration, the prevalence
of the disease was mainly confined to the northern parts of
the parish in the first instance, and subsequently to the southern
parts. It has persisted for a longer period in the south during the
present epidemic, and I am bound to believe that it has done so owing
to the re-introduction of infection from adjoining parishes, especially
Fulham, where according to the report of the Medical Officer of
Health, very many cases have been concealed and kept at home.
Some cases no doubt are so effectually concealed that we never hear
of them at all, and in other instances the presence of the disease is made
known only on the registration of a death. In a case of recent occurrence
an outbreak was concealed for some time by the supression
of the "primary disease" in a medical certificate of the cause of death; a
death really due to small-pox, having been attributed to the secondary
cause only, viz., congestion of the lungs. In a few instances the first
case in a family was of so trivial a nature as to have been mistaken
for chicken-pox, the mistake not being discovered until too late to
prevent the spread of the disease, nor in fact until the occurrence of
second cases (one or two of them fatal) left no room for doubt. In
several instances there was exposure of the sick in public places and
in public conveyances—but with what evil consequences can only be
surmised. On the whole we have not much reason to be dissatisfied with
the amount of success that has attended our efforts to get the sick removed
to hospitals; though objections have been raised in a few instances,
sometimes because the case was of so trifling a character, and sometimes
because of the severity of the illness. It is not easy to say
which class of cases does the greater public harm, the lighter in which
it is difficult to keep the "sick" at home for the period requisite
for complete recovery, so as to prevent them from spreading the
disease; or the more severe in which a large amount of infective
matter is thrown off by the skin, lungs, &c., to the great danger of
the other inmates of the house.