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109
was 17. This represents about 170 persons attacked. Of the
170 persons supposed to have been attacked 108 were discovered
and 62 are supposed to have been concealed. Estimating that
there were 12,510 persons attacked by the disease in London
and 170 in the Fulham District, the proportion of persons
attacked per 100,000 was 311 in London. The proportion
of persons attacked by the disease per 100,000 of the inhabitants
in the Fulham District was 121. The proportion of persons
attacked by the disease in the whole of London was therefore
last year more than twice as great as in the Fulham District.
There can be no doubt that there would have been a much larger
proportion in the Fulham District than in all London but for the
course that has been adopted by your Board. The cases of
smallpox reported in the Fulham District during the last eight
years from 1877 to 1884 both years included were 1877—328;
1878—266; 1879—166; 1880—51; 1881—327; 1882—16; 1883—
0; 1884—108. I regret to state that the recommendations
contained in the report of the Royal Commission which sat in
1882 have not yet been acted upon by the passing of a Bill to
ensure the notification and proper isolation of infectious diseases.
Smallpox will never be effectually dealt with until some such Bill
be passed. Of the 108 cases of smallpox reported last year there
were 43 in the Parish of Hammersmith against no case in the
previous year, and 65 in the Parish of Fulham against no case in
the previous year. It is a remarkable fact that when smallpox is
epidemic there is always a larger number of cases of smallpox in
the Parish of Fulham than in the Parish of Hammersmith,
although there is in the Parish of Hammersmith a very much
larger population. The difference in the proportion of cases has
continued to decrease during every year that I have been in office.
I attribute this fact to the improvement that has taken place in
reference to the measures adopted to ensure the isolation of the
disease. The evidence obtainable on the subject is certainly in
favour of the theory that the Fulham Hospital has to a slight
extent been the means of increasing the difference in the proportion
of cases in the two Parishes. There can be no doubt however
that the presence of the hospital has been the means of very
considerably decreasing the actual number of cases in both
parishes. But for the presence of the hospital near at hand to
which the worst cases could be removed, these cases would have
been left at home without proper isolation. They would have
done very considerably more to increase the number of cases in
the Parish of Fulham than the hospital could do. If however
there was no smallpox hospital in the Parish of Fulham I should