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as well-spotted maps, the distribution throughout a district of cases of, or deaths
from, special diseases.
I have, for many years, introduced Table I* so that the reader may readily
contrast the mortality per cent, from each class of disease, to total deaths for
Whitechapel, and also for the entire Metropolis including Whitechapel. Just
those diseases which are caused or aggravated by the necessity for living in
crowds, and by exposure in all kinds of weather, such as constitutional'
diseases, and diseases of the respiratory system, claim more victims from our
own people, whereas curiously enough a smaller percentage of deaths from
zymotic diseases is recorded than for the whole of London. This has been
the experience for some years past. I cannot help thinking that much of this
advantage has been due to the special care given by Mr. Shepherd, in every
case of infectious disease. Not only are the notifiable diseases looked after in
the manner customary in all sanitary areas, but deaths from measles, and deaths
from phthisis, are treated in a similar manner. Of course much tact is
required to obtain consent in every case, but such consent being refused has
not been brought to my knowledge.
Only one case of small-pox during the year was credited to Whitechapel.
The patient contracted the disease in. a West End District, and during the
the incubation period she spent a week end in our District. Practically, therefore,
Whitechapel has been clear of small-pox.
Two years have now elapsed since the new Vaccination Act came into
operation. It was passed as a five years' experiment. So far as one may be
able to judge from its working in Whitechapel, it would appear to be successful.
That is to say, 315 more cases were vaccinated by the Public Officers during
the past year than were vaccinated during the year which preceded the commencement
of the new Law. The Glycerinated Calf Lymph supplied from
the National Vaccine Establishment of the Local Government Board is free
from those organisms which are sources of inflammation and even worse results.
However, it cannot be denied that there are many unprotected persons now
living in our midst who are a danger to others as well as to themselves.
The extracts from the Reports published by the Metropolitan Asylums'
Board which I have introduced, sufficiently explain themselves; it will be seen
that nearly five millions of persons can only now contribute one case of smallpox.
I again assert, on the evidence derived from every epidemic of small-pox,
as well as from that produced before the Royal Commission on Vaccination,
that vaccination alone is responsible for this condition.
In comparison with previous years it will be noticed that many more cases
of notifiable infectious diseases have been registered during the past year, but
the diseases have been of a comparatively mild type, and the mortality has been
very low. In this connection 1 have to offer my thanks to the Officers of the
Metropolitan Asylums' Board for the assistance they have given in arranging for
the early removal of cases. At a time when a block occurred in the removal
of some cases of enteric fever, I wrote to the Clerk of that Board, and immediately
he courteously received our cases, much to my relief.
The fees paid during the year under the Notification of Infectious Diseases'
Clause of the Act, amounted to the sum of £92 14s., as against £75 10s. 6d.
for the previous year. Many of the cases were notified by more than one
practitioner. In one case four certificates were received for one case of
1 ervsipelas.' This is not the fault of the doctors, who are legally bound to
notify every case which comes within their practice, but of the wording of the
Act itself.
* Page 28.
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