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36
A few illustrations shewing how the disease got spread may
not be without interest. The first set are taken from my January
report.
In three houses the nature of a primary case of illness was not recognized.
In one instance the case was that of a servant, not ill enough to lay up. She
went about her work as usual, and infected a fellow servant and two children
in the same house. In a second instance a child supposed to be suffering from
chicken-pox, but not ill enough to lay up, infected three other persons in the
same house with small-pox. The disease appeared at the same time in two
other houses in the same street, but whether in connexion with the primary
case in the above group could not be established. In the third instance, two
secondary cases occurred; one proved fatal.
In February, five cases—mother and four children—occurred simultaneously,
at a public-house in North Kensington. The common origin doubtless was an
unrecognized case. The patients were treated at home, but the disease did not.
spread.
In March five cases occurred among the members of a "nigger troupe." It
was not clear whether the patients were infected by an unrecognised case
among their own body or by the "properties," which had been purchased in
Petticoat Lane about a fortnight before the occurrence of the first of the cases.
In this month secondary cases were recorded at three houses, which had
been thoroughly disinfected, and long after the removal of the primary cases.
It appeared on enquiry that the sufferers had received letters from sick friends
in hospital—a fact which, it was thought, might possibly account for the
infection. Patients were rather encouraged to write home. Put the practice
cannot be held free from risk, and it is one that might be restricted with
advantage, there being no doubt that susceptible persons may be infected by
contagium harboured in a letter. A card would be less dangerous than a closed
letter, as it might be disinfected before being posted.
In April each of two unrecognised cases was followed by a fatal secondary
case. In a third house a secondary case occurred, and in a fourth house three
secondary cases were the result of failure to recognise a primary case, the
nature of which was not even suspected until report of subsequent cases led to
visitation. In a fifth house delay in removal of a first case led to the
occurrence of other three cases. In a sixth house there were two secondary
cases, and in a seventh house one such case. Delay in removal was but too
common, especially in North Kensington, with results as above set out. In
this month two persons contracted small-pox by indiscreetly visiting sick
friends.
In May five cases in five houses were secondary to cases previously sent to
hospital from the same houses. In one family there were five cases, all of
children, which appeared to have originated from infection received by a boy
from another boy at a school in a neighbouring parish. The children, it was
said, were prematurely exposed during convalescence and allowed to mix with