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58
prior to July, explains the widely varying incidence of the
disease in the different districts, and the spread of smallpox
in the northern and eastern districts up to that
date, and the absence of spread in the Southwestern
and the South-Eastern districts at the critical
period in March? And as the atmospheric conditions to which
the outbreak in the North and the East districts was attributed
must have prevailed in the South-Eastern and the South-Western
districts also, in which districts, moreover, small-pox hospitals
were in use, it becomes an interesting further question, whether
any particular number of cases is necessary, in the same atmospherical
conditions, to ensure spread of the disease in a hospital
district? These questions, to which I do not profess to be able to
give a decisive answer, will be considered in the following section
of the report.
I pass on, therefore, to observe that the facts already stated (and
tabulated in Table I) shew that there was no marked spread
of small-pox in London in February; nor in March, save in the
northern and eastern districts, as defined in the Tables published
by the Asylums Board, and that the epidemic began in that month
at Hackney and adjacent parishes. Of 52 cases admitted at the
hospitals in the fortnight February 16th-29th, 44 were admitted
at the Eastern Hospital: 21 came from Hackney; and 6, 4, and 5
from Bethnal Green, Poplar and Islington; so that these four
parishes contributed 86 out of 52 total admissions. The same
parishes and Shoreditch (7 cases) contributed 39 out of 52 cases
admitted at the hospitals in the fortnight ended March 14th; 44
of the cases having been admitted at the Eastern Hospital. In
the next fortnight, the critical period March 15th-28th, the
admissions at the hospitals sprang up to 164 (136 at the Eastern
Hospital), and 141 patients were admitted from the parishes above
mentioned, including Hackney 89, Bethnal Green 16, Islington
18, and Shoreditch 18.
With fluctuations, well shewn in the Tables, the epidemic
continued to increase until the middle of June, but, curiously
enough, the admissions in the two fortnightly periods after March