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27
Common Houses, the necessity for complying with the
directions contained in (my) circular letter." Shortly after these
directions were given a female casual was discovered to be ill
with Small-pox, and two male lodgers from Common Lodging
Houses also. The several patients were removed to hospital,
and, so far as I could ascertain, the disease did not spread.
It may be mentioned that on the last day of the official
year, 1892-93 (March 25th), there were 240 cases of Small-pox
under treatment, viz., 228 in the Asylums Board Hospitals,
and 12 in the London Small-pox Hospital, Highgate: 256
cases had been notified, and 20 deaths had been registered, in
the four weeks ended on that day.
A common cause of the spread of Small-pox is the
inability of many medical men to recognise the disease, which
few of them have had opportunity of seeing. A very
striking illustration of this kind occurred in the early part of
the present year. The facts of the case, as set out in my
second monthly report, are worth quoting, as follows: —
"Four cases of small-pox notified in this parish occurred in one family, three
of them being the consequence of failure on the part of a medical
practitioner to recognize the nature of the first case, under circumstances
which might well have excited suspicion and prompted measures of a
precautionary nature. The first case, moreover, illustrates the remarkable
power of small-pox infection to pick out and strike susceptible persons,
instanter; whilst incidents in the course of it serve to show how disease
may unconsciously be spread by an infectious person. The facts are as
follows:—At the end of the third week in January a young man who had
just obtained his medical qualification, saw, in company with a number
of medical students, in the out-patient room of a general hospital, a man
who had small-pox, the eruption being pretty plentiful and in the pustular
stage. lie was not within fifteen feet of the sufferer, and was not in the
room with him more than two minutes. Nevertheless he (and as it
appears one of the students also) fell ill on the thirteenth day afterwards,
viz., on February 1st, with febrile symptoms indicative of small-pox,
followed on the 4th, by the characteristic rash. He saw a medical
friend, not resident in Kensington, whom for brevity I will call
Dr. Blank, and told him he had small-pox. This gentleman, however,
formed the opinion that the case was one of chicken-pox; and, most