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since my appointment in 1856. In all London it was 20.4, or
nearly 3 per 1,000 above that for Hackney, so that we still keep
our position as regards healthiness, not only relatively as
compared with the Metropolis as a whole, but absolutely as
compared with the returns in former years.
There have been several rather unusual cases of small-pox
in the District during the year. I do not mean unusual as
regards their course, but as to their cause. One occurred in the
Boys' Refuge at Urswick Road, a little more than a quarter of
a mile from the Small-pox Hospital, at a time when there was
no other case near. The lad had not been out of the School and
grounds for two months before the attack, nor had there been
any boy brought in for more than a fortnight before, except
one, and he came from a locality not infected with the disease.
Another case was that of a cripple who had not been out for
some months, who also lived about a quarter of a mile from the
Hospital, and who had not received any visitors for some time,
except his mother and sister. A similar case happened at a
Refuge for young women, but as washing was taken in there
it is possible that the infection might have been conveyed by
the linen or blankets. Enquiries were made as to the source of
infection in every case, but a satisfactory answer was rarely
obtained. The proportion of children under 10 was not so
large as in previous years, showing that efficient vaccination has
not lost its protective power. It must not be supposed that even
effective vaccination in infancy is a protection against the disease,
any more than one attack of small-pox is absolutely protection
against a second. So far is this from being the case, I had
two fatal cases in former years, under my own treatment, which
occurred in persons who were deeply pitted from small-pox.
The protective power of vaccination is not greater than that of
a prior attack of the disease, but as small-pox is so fatal in
unprotected persons, and comparatively so mild in protected, it
is surely little better than an infatuation for persons to refuse
protection at so cheap a rate as that afforded by vaccination
and re-vaccination.