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once reported to Mr. Matthews, the Vaccination Officer; the adults in
infected houses urged, in a great many instances successfully, to avail
themselves of the protection afforded by re-vaccination ; and the Board
and other school officials informed of those houses in which infectious
disease existed in the vicinity of the several schools. From the result
of the enquiries I found that a very large proportion of the cases in the
early stages of this epidemic originated in houses occupied by customhouse
officials, dock labourers, and persons engaged in cleansing and
making up imported articles, such as feathers, etc. It would appear
from this that the epidemic may have been sustained or even originated
through these channels. This is a subject which merits further consideration
and investigation, although it would of course be attended
by great difficulties.
Until January, 1881, the cases were for the most part sent to
hospital at the expense of the Vestry, but latterly the Guardians have
undertaken the removal of all patients who are unable to pay the fees
for the private hospital. In March, 1881, all the small-pox hospitals
were full, and much difficulty was experienced in getting the patients
removed. Sometimes a case had to be kept at home in a house occupied
by several families for many days until a vacancy occurred in one of
the hospitals. In many instances where this was the case, the disease
spread not only to other occupants of the infected house but to several
houses in the same streets. This should surely teach us the value of
small-pox hospitals. When a case is treated at home the house becomes
a centre of infection, for it is impossible to efficiently isolate patients in
small crowded houses ; and when we consider that washing, mangling,
tailoring and many similar businesses are frequently carried on in the
same house, sometimes even in the same room which a small-pox patient
is occupying, perhaps for several days before the case is reported to the
Medical Officer, it becomes apparent how very serious the danger of
extension must be. It may be urged that a small-pox hospital is also a
centre of infection ; that it is so to a certain extent may be correct—that
it ought not to be I assert without hesitation; and should these hospitals
ever be closed the consequences must be most serious, unless, indeed,
the public could be taught to understand that, rigid sanitation, aided by
efficient vaccination and re-vaccination, are an absolute protection from,
and prevention against, the disease; and even then the un-vaccinated
population (viz.: newly-born infants), must always be very considerable.
In March, the Guardians came to our assistance by opening the
infectious wards of the Workhouse Infirmary for the reception of these
cases. Thirty-two cases were treated there, and of these two died.
Considering the difficulties experienced by the authorities in providing
nurses and attendants at so short a notice, the sanitary and other
arrangements were carried out in a most satisfactory manner under the
able superintendence of the Medical Officer in charge, Dr. Atkins, Jun.,
to whom I was indebted for daily reports at this period. When the last
patient was discharged the wards were disinfected and cleansed. Not
a single case in private dwelling-houses in the immediate neighbourhood
of the Infirmary was reported to me, thus showing what can be done
to prevent the spread of the disease in the vicinity of small-pox
hospitals when the proper sanitary measures are adopted.
During the twelve months ending March 31st, 1881, sixty-four patients
were removed to hospital from this Hamlet, and 13 deaths occurred