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69
1879 respectively. From the very small number of deaths from
smallpox (only one) registered as occurring in a private dwellinghouse
last year, we may with certainty conclude that there were
very few conccaled cases, while there were about 200 the previous
year. Under such circumstances, therefore, it is not surprising
that there were so few cases in this district.
Of the 51 cases which were reported last year, there were 42
in the parish of Fulham against 133 the previous year; 9 in the
parish of Hammersmith against 33 the previous year. This
diminution in the number of cases is satisfactory, and particularly
so when it is remembered that the epidemic was more prevalent
in London as a whole last year than the previous year. These 51
cases occurred in 40 houses in 34 streets. In 27 streets the
outbreak was confined to 1 house in each street; 22 cases occurred
singly in different houses in different streets. In 7 streets there
was more than one house infected in each street. In each of these
7 streets there were 2 houses infected. In 33 houses there was
only 1 case in each house. In 7 houses there was more than 1 case
in each house. Thus, in 1 house there were 5 cases; in 1 house,
3 cases; and in 5 houses there were 2 cases in each house. Of
the 51 persons attacked, 25 had been once vaccinated, 4 had
never been vaccinated. In the remaining 22 cases no information
as to vaccination was obtained. In no case was
evidence obtained that the patient had been re-vaccinated. The
ages varied from 2 weeks to 74 years; the average age was 25.2
years. Of the 51 cases 11 deaths were registered, which equals
a mortality of 21.6 per cent. This is a somewhat high mortality,
but it can not be taken as reliable, for there is always a proportion
of cases that are concealed and treated at home. These,
for the most part, are the slight cases. The period of illness is
only a few days, and the patient almost always recovers. It is
from the slight modified cases that the disease frequently spreads.
Owing to the trifling symptoms the patient has shown there is
very little alarm on the part of the relatives, and commonly no
isolation or disinfection is adopted. Under proper precautions
there would not be anything like the same chance of the disease
being propagated from a modified as from a severe one, but as a
matter of fact, the neglect of precautions in the modified cases
makes them a means of greater danger than the severe cases
that are, as a rule, properly dealt with. Of the 51 cases
reported 46 were removed by your Board and properly isolated;
45 were taken to the Metropolitan Asylum Hospital at Fulham,
and 1 to the Metropolitan Asylum Hospital at Stockwell;5
cases were treated at home. The per centage of cases removed
to hospitals was 90.2, as compared with a per centage of 83.8 in