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12
Scarlatina, as usual, was the most fatal of the strictly
epidemic diseases. It prevailed most extensively during the cold
months of the year. Thus, during the summer six months
there were 120, and during the winter six months 177 fatal
cases.
But small-pox was unusually fatal, chiefly during the latter
part of the year ; and this fatality continued during the succeeding
spring and early summer of 1860. The mortality from smallpox
in Lambeth, in the successive four quarters of the year 1859,
rose progressively as follows:—4, 7, 10, 38. Small-pox, like most
epidemic diseases, has its periods of exacerbation and remission;
and the winter of 1859-60 was a period of exacerbation. In
respect of small-pox, however, Lambeth stood out favourably when
compared with the Metropolis as a whole. Had its mortality
from that disease been equal to the average of London, there
would have been 67 deaths to record instead of only 59. The
character of the small-pox was somewhat peculiar. The eruption
in general was semi-confluent, indicative of a rather severe form
of the disease; but nevertheless the mortality, in proportion to
the number of cases, was very small. Thus, in the last quarter
of the year 1859, according to the returns of the Poor Law
Medical Officers, 182 fresh cases of small-pox occurred in the
pauper population alone, while the cases in the entire parish furnished
only 38 deaths. The late epidemic awakened public
attention to what had been well known for a long time past
among medical men, namely, that the provisions of the Vaccination
Act were being very imperfectly carried out. One great
purpose of an epidemic seems to be that of pointing out sanitary
evils, and directing the efforts of mankind to their amendment.
In this way, the epidemics of fever and cholera which characterised
former years, by promoting the advance of sanitary measures,
effected a great and permanent good. It is to be hoped,
that the late epidemic of small-pox may have a similar effect, and