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in Utrecht, 25 in Rotterdam, and 3 in Amsterdam. It is well known
that among the lower classes in Holland a very strong prejudice
exists against vaccination. It may be useful to inquire what might
be the result in London if prejudice against vaccination, which is so
strongly held by a few in this countiy, should ever become so widely
spread as in Holland. If the same death-rate from small-pox had
prevailed in London during the Quarter as existed in The Hague
during January and February, the deaths from this disease within the
Metropolitan Division would have been 38,828 during the 3 months,
instead of the 2400 which actually occurred."
At pages 11 and 12 of my Quarterly report ended April 1st, 1871,
it is stated on the authority of the Registrar-General, that during the
first three months the mortality from small-pox in the Whitechapel
District was 95, including 12 deaths which occurred in the
Small-pox Hospitals of persons belonging to the District; in London
during the same period the deaths from this disease were 2400,
which gives a mortality at the annual rate of 3.0 per 1000 of the
estimated population. Large as was the mortality in this district and
in London, it was small when compared with the mortality at Rotterdam
and The Hague during the same period. In Rotterdam the rate
of mortality from small-pox was 31.7 per 1000 of the population, and
in The Hague 41.2. In both these cities vaccination is much
neglected.
As regards the extent of vaccination in this country the RegistrarGeneral
remarks that the information respecting vaccination, or
otherwise, in fatal cases of small-pox is necessarily incomplete, failing
the co-operation of the medical profession. In but a small proportion
of the cases does the certificate of the cause of death state whether
the deceased has been vaccinated or not; and although the Registrars
have in some cases been instructed to enter this information in the
death register on the authority of the informant, it is to be feared that
this is not always reliable. Frequently the informant is not aware of
the fact; and it is suspected that in many instances vaccination is
falsely stated to have taken place to conceal the neglect on the part
of the parents, who have some dread of legal proceedings.
Census Return for the Whitechapel District.
From a preliminary statement of the result of the Census for
1881, kindly furnished to me by Mr. Vallance, the Clerk to the Board
of Guardians, it appears that the population of this District is less by
5,297 than it was in 1871, the time when the last census was taken.