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18
With two good marks 157
„ three marks 213
„ four marks 126
„ five or more marks 62 Protected 558
The large proportion, therefore, of 15 percent. was found wholly unprotected.
In others of the metropolitan districts this per-centage has been usually found to be
ten or twelve only. Another twenty-three per cent., too, were very imperfectly
secured against smallpox.
Every house that became infected was anxiously examined, the vaccination of its
inmates assured, and means suggested for preventing contagion. The Sanitary Inspector,
meanwhile, was busily inquiring from house to house in the infected neighbourhoods
as to the existence of new cases, and as to the performance of vaccination ,
and he brought to light nearly a hundred cases where the operation had been omitted.
In these steps that were taken for the detection of unvaccinated persons, and for
rousing them to a sense of their danger, I was greatly assisted by the advice and
co-operation of Dr. Seaton, who was appointed by the Privy Council to make inquiries
on the epidemic of smallpox, and the state of vaccination in the metropolis.
The greatest facilities for vaccination were afforded to every one who applied by the
Public Vaccinators, Messrs. Bennett and Knaggs; and in order to meet the requirements,
frequently urged, of people who object to apply at the workhouse, Mr.
Cooper, the Surgeon of the Bloomsbury Dispensary, kindly undertook to vaccinate
at that institution. Moreover, in the third week of January, finding that smallpox
was continuing its ravages, Dr. Seaton prevailed on the Public Vaccinators to visit
systematically, lancet in hand, from room to room, through the infected streets. Large
numbers of children were thus reached whose parents had been too supine to take
them to the operator.
The number of vaccinations by the Public Vaccinators now rose from an average
of fifty in the fortnight, at which they had stood during the last quarter of 1859, to
a hundred and forty-three in the first half of January, and five hundred and sixtyseven
in the second half. In addition to these, 76 persons were vaccinated in
January, at the Bloomsbnry Dispensary, making a total of 786 persons gratuitously
vaccinated within the month. Of the cases operated on by Messrs. Bennett and
Knaggs two-thirds were above one year of age, and 169 of those vaccinated in
January were entirely unprotected. Considerable arrears and long neglect were
therefore made up in a few weeks, and nearly 100 persons whose scars showed
them to be imperfectly kept from smallpox received the benefit of a second vaccination.
These figures do not include 126 children of the Refuges in Great
Queen-street and George-street, who were vaccinated later on, in February, by
Mr. Spencer Watson. Of these 126, fifteen only were wholly without vaccine
marks, yet the operation was perfectly successful in 39 cases, and partially successful
in forty-two.
The result of this great extension of vaccination was shown in the diminution of
Small-pox mortality between January and February. That this diminution did result
directly from the vaccinations, and not from the epidemic spontaneously exhausting
itself, is shown by some very interesting considerations derived from
the medical practice of the workhouse, which were first pointed out to me by
Dr. Seaton:—
Of the cases of smallpox that came under treatment by the workhouse surgeons,
the number among unvaccinated persons fell very remarkably just at the time when
the community had become better protected by the measures above detailed. It
was in this class of patients exclusively that the deaths occurred. We may therefore
conclude that the fall in the mortality of small-pox resulted from the extinction
of this class of unprotected persons, unless it should be shown that the epidemic
itself had notably abated its violence at this very moment. This, however, was
positively not the case, for among those who were partially protected by vaccination,
and therefore had the disease more mildly, as large a number of smallpox cases
occurred for some time after this wholesale vaccination as before. It seems, therefore,
certain that the only circumstance to which we can ascribe the saving of some