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62
But it is said, and not by Mr. Power only, that the dissemination
of small-pox matter through the atmosphere is always
most marked "at the commencement of an epidemic,''* and
therefore such outbursts were not to be looked for at later
periods ; when, moreover, it came to be " seen that a considerable
proportion of small-pox cases in the special area were in
persons who had had more or less opportunity for getting
small-pox in a commonplace way by communication with
persons or things previously infected," So, then, it would appear
that so few as ten to twenty acute cases in hospital will suffice
to produce small-pox matter adequate to infect the "\special
area," i.e., a circle two miles in diameter (=31/7 square
miles), at the commencement of an epidemic, given a particular
condition of the atmosphere favourable to its spread;
aye, and at a bound will do more mischief than three times as
many acute cases in hospital when the epidemic is at its height:
when, moreover, the district is, so to speak, full of infection,
and the small-pox kept at home is admittedly adequate to
explain the spread of disease in "commonplace ways." It is
hard to believe!
Mr. Power's fifth proposition reads thus:
"The appearance of excessive small-pox in houses around the hospital has
never been delayed until the hospital has become full, or nearly full.
It has been always most remarkable at the time when admissions to
the hospital were beginning to increase rapidly.
"In the succeeding months of active operations, though the use of
the hospital may have gone on increasing, the excess
of small-pox upon the neighbourhood has habitually
become less marked."
The statement in the sub-section, at any rate, is true enough ;
whether it is consistent with the theory of aerial infection is
another question.
29 in the special area, the houses newly invaded from 41 to 21; and in the three
following fortnights (to April 2, when Mr. Power's enquiry ended) the new cases
were 59, 59, and 41, of which 38, 28, and 26 were in the special area.
*Dr. Bristowe observes with reference to Deptford Hospital that "the tendency
of cases to aggregate round the hospital is usually at the close
of an epidemic." (488.)