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that during the early weeks of this current year 1871 the mortality has
more than doubled this remarkable amount. The Registrar-General states
that an epidemic of small-pox has occurred during the past 30 years about
once in every three years, attaining a maximum of severity about once in
every five years; that in the 31 years 1840—70 the annual deaths have
averaged 808; the lowest number of deaths in any one year having been 154,
and the highest 2,012. The number of deaths in 1870 was 958; but of these
so many as 584 occurred in the last quarter.
24. The first cases of this epidemic in St. Giles District of which I
could get information occurred in two members of one family at No.
27, Crown Street, on February 3rd. The disease, however, does not seem
to have spread from them to others. It became localized about a fortnight
later in the Colonnade at the other end of the District; and there is
evidence to show that it entered our District from St. Paneras.
25. On the 1st February Dr. Stevenson, the Medical Officer of Health of
St. Pancras District, kindly wrote to me to inform me of the fact that several
cases of small pox had been reported to him bordering upon St. Giles District,
viz., at 14, Colonnade 8 cases; 7, Colonnade 2 oases; and at 39, Colonnade
others. I instantly instituted inquiries, and was able to assure Dr. Stevenson
that, at that time, there were no cases of small pox in that part of the Colonnade
which is within St. Giles District. A fortnight afterwards, however,
(just the period of the incubation of the disease) on the 15th February our
first case was reported at 22, Colonnade, and in the course of the next five
months we had 25 cases in the Colonnade and the Little Coram Street section
of the District. There seems reason to believe, therefore, that the epidemic
approached us through the streets contiguous to St. Paneras. That parish, in
its turn, probably received it from its nearest Eastern neighbour; but under
what circumstances it became prevalent in the East of London, whether it
originated there or was imported, and, if imported, whence, are yet open
questions. The determination of these questions is of the utmost importance
to the solution of the further question of the possible stamping out of the first
sparks of these spreading diseases. Statistical returns have their use in setting
forth a certain class of facts and in showing, inferentially, the conditions
favourable to the dissemination of epidemic diseases, and they point the way
to practical effort; but the way must be followed until we arrive at the source
of contagion. To the extent that the spread of a disease like small pox
depends upon contagion from person to person—and, I believe, that its propagation
is almost wholly, if not altogether, due to this cause,—the seizure
and isolation of the first case is of paramount importance. Unfortunately,
however, there is no organization equal to the work; and no law adequate to
give effect to such organization if it existed.
26. I am unable to state the number of attacks of small pox during the
year, as there are no reliable means of obtaining such facts; but the deaths
were numerous. Only 5 deaths are recorded in the local Registers; but in
addition to these there were 11 that occurred in Hospital, making an aggregate
of 16,—just our proportion of the aggregate Metropolitan mortality.
In the three previous years, the mortality had been as follows:—in 1867,
31 deaths; in 1868, 6 deaths; in 1869, 1 death. In 1870 the epidemic was
gathering strength for its culminating energy in the current year 1871.
Some of the persons (at least 5) who died had not been vaccinated,—notably
three children at 10, Lumber Court who had come from St. Paneras, and
whose father declared to a prejudice against the operation. One child was
attacked with small pox two days after vaccination, and died. In this case
the vaccination was no protection, the virus not having gone through its
regular course in the system; for it is now well understood that unless the
process of vaccination is completed by the usual local and constitutional
developments the individual is not protected.
Vaccination and Re-vaccination. 27. The importance of vaccination
cannot be doubted both in preventing attacks and in modifying them when