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22. The actual rate of cases to population, for the whole year, was 9.9
per 1000 persons living, and the actual rate of deaths to population was 1.64
per 1000 persons living.
23. The distribution of the cases among the three sub-districts was as
follows:—St. George, Bloomsbury, 160, St. Giles South 187, St. Giles North
180, besides four others who were brought into the district from outside
parishes.
Summonses against a Master and Medical Attendant.
One of these was a journeyman baker, who had been sent from Isleworth,
and had travelled by train to London. A summons was taken out, by
the direction of jthe Magistrate, against his master and the surgeon who
had advised his being sent, knowing him to be then suffering from Small
Pox; but in consequence of the death of the man in hospital, his evidence
was lost, and the defendants were acquitted. The issue of a summons
against the surgeon, under " Jervis's Act," should operate as a caution to
medical practitioners who give injudicious advice under such circumstances.
Small Pox in Common Lodging Houses.
25. One peculiarity deserving of remark, in respect of the local prevalence
of the epidemic, is the small number of cases (15) that occurred in
common lodging houses. It may be remembered that, during the epidemic
of relapsing fever, a very large preponderance of attacks happened in those
houses ; and I attributed the fact, chiefly, to the importation of the fever by
tramps and hop-pickers from country parishes. On the occasion of this
epidemic, notwithstanding its highly contagious character, an opposite fact
has been noticed; and I can only attribute the comparative freedom of
common lodging houses from Small pox to the prompt and rigorous measures
of isolation and disinfection which were carried out by the police authorities.
It is fortunate that Small pox evidences itself early by eruption : on the first
indisputable sign, therefore, of the malady, and before the contagium became
energetic, the police inspector was able to send the cases to hospital; and by
requiring the immediate clearance and disinfection of the rooms, and keeping
them empty for two or three days, as might appear necessary, in no instance
was the disease propagated in these overcrowded houses. The inspector of
police reported to me the cases as they occurred, and received my certificate
of the fitness of the rooms for occupation before they were re-occupied. The
energetic conduct of these measures, by the Serjeant in charge of the duty,
deserves commendation.
26. The disease spread, chiefly, among families of children, where the
same decisive measures of isolation, &c., could not be carried out. The whole
of one family, residing in the Model Lodging House, in Streatham Street,
were attacked; three of them were sent to hospital, and two remained at
home; but, owing to the facilities for isolation which this building affords,
the disease did not spread from them to other families. This family had
come into the Model House, from Bedfordbury, only about a fortnight before
the first attack, and probably brought the seeds of tho disease with them.
The father had been re-vaccinated seven days before the attack, but not a
sufficient time for the constitutional changes to have been effected. The
attack, however, was not severe.
Vaccination as a Preventive.
27. Of the whole number of cases in which the fact could be ascertained,
451 had been previously vaccinated, and 54 had never been vaccinated.
Among the vaccinated there were 56 deaths, or a rate of 12.4 per cent. ;
amongj the uuvaccinated there were 29 deaths, or a rate of 53.7 per cent.
The deaths icere therefore about 1 in 8 cases among the vaccinated, and more
than 1 in 2 among the unvaccinated.
28. It is thus evident that the mortality was at least four times greater
among the unvaccinated than among the vaccinated ; and we must presume