London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Whitechapel 1876
[Report of the Medical Officer of Health for Whitechapel]
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From the foregoing returns it would appear that temperature does not materially
affect the mortality of small-pox.
Small-pox, like other epidemic diseases, is of periodical recurrence, hut
the interval between the return of each epidemic is not of uniform duration.
An interval of six years has intervened since the last epidemic in 1871; and
the epidemic preceding that of 1871 occurred in 1863, when the mortality
was 2,012, in a population of 2,803,989; whereas, the population in 1871
was 3,251,804, and the deaths amounted to 7,876; the former giving a rate of
mortality of 0.71 per 1,000, and the latter, as before stated, of 2.4
per 1,000.
On referring to Table VI. in the Appendix to this Report it will be
seen that small-pox is never entirely absent from the population of London.
Every year shows that a certain number of deaths occur; the lowest number
in any one year was in the year 1874, when only 56 deaths occurred. In
the year following the deaths were 75, and the cases probably amounted to
about 450. In the unvaccinated cases nearly the half die; in the imperfectly
vaccinated about 25 per cent. die, and in the well vaccinated cases the
mortality is only 0.4 per cent.
The practice of variolous inoculation has long ceased to be practised in
this country. It was discontinued in the Small-pox and Vaccination Hospital
in June, 1822. From the records of that hospital we learn that the rate of
mortality from small-pox in London in those who had been inoculated was
about 1 per cent., while its fatality in those who had not been inoculated
was about 18 per cent.
DEATHS from SMALL-POX in LONDON, during the fifty-two weeks ending 30th December, 1876, at Six Groups of Ages.
| At all ages. | 0-1 | 1-5 | 5-20 | 20-40 | 40-60 | 60 and upwards | |
|---|---|---|---|---|---|---|---|
| Certified as Vaccinated | 219 | 6 | 6 | 49 | 123 | 33 | 2 |
| Certified as Un-vaccinated | 325 | 47 | 81 | 88 | 93 | 12 | 4 |
| Not stated as to Vaccination in Medical Certificate | 191 | 35 | 38 | 38 | 53 | 24 | 3 |
| Total | 735 | 88 | 125 | 175 | 269 | 69 | 9 |
The Registrar-General states that of the 735 deaths 338 occurred in hospitals
and 397 out of hospitals.
The mortality, says the Registrar-General, during the present epidemic,
in the Hospitals has been higher than it was in the preceding epidemic.
"During the London small-pox epidemic in 1870—1—2, 14,808 cases
were treated in the Metropolitan Asylum Hospitals, showing a mortality
equal to 18.7 per cent. During 1876, the number of completed cases treated
in the same Hospitals, was 1,377, and the 338 deaths (46 per cent. of all the
small-pox deaths in London), were equal to a mortality of 24.5 per cent."
The increase in the rate of mortality in 1876 above that in the last epidemic
was 5.8 per cent.