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19
a circular note is left at each house by the Inspector in charge
of the disinfection, pointing out the protection afforded by
this simple operation. I have also had nearly 6,000 handbills
distributed amongst the poor, through the clergy, district
visitors, masters of the School Board and other elementary
schools. If I had received early notification of the existence
of small pox, especially amongst the poor, I could have taken
measures in many cases by disinfection, and perhaps, compulsory
isolation for preventing of the spread of the disease.
Amongst the 800 cases reported to me between August
1st, 1880, and the end of May, 1881, when this part of my
report was written, I found that 602 patients had been vaccinated,
90 were unvaccinated, and no information could be
obtained respecting the vaccination of 108, very many of the
latter being servants. I would remark here on the very large
number of instances in which servants were the only members
of a family affected, whilst it frequently happened that
two or more children were attacked simultaneously in poor
localities, especially when attending the School Board's
schools. There were comparatively few children under five
years of age, attacked during this epidemic, as compared
with 1871-72, or even with 1877-78; but there was a very
large number between 5 and 15, viz., 25 per cent. of the
whole. There was a very large proportion of cases under 15
years amongst the vaccinated, which shows that re-vaccination
to be at all effectual in stopping the spread of small pox,
should generally be performed at an earlier age than 15
years. If however, there should be three or four good marks,
it might be deferred to 15 years. I have seen a large number
of small pox patients in the hospital and elsewhere, and am
convinced that in very many instances, vaccination has been
very carelessly performed, and has not afforded proper
protection against an attack. It is also necessary that as
much care should be taken in re-vaccination as in primary
vaccination, both as regards the lymph and prevention of
damage to the vesicles. If a person have been re-vaccinated