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attendants employed; 30 of these had previously had Small Pox, but
none of the others suffered from the disease.
At the Sheffield Hospitals the staffs numbered 143; of 80 who
were re-vuceinated ax adults not one contracted Small Pox, whilst of
(12 who had not been re-vaccinated 5 suffered from the disease, as did
one other who was not successfully re-vaccinated until he was sickening
from the disease.
At Warrington, Homerton, Fulham, and your own Hospital at
Tottenham, the experience has been similar. I will not weary you
with the details of these since they merely confirm the conclusion that
even the nurses—who are exposed to a concentrated form of infection
for longer periods than the Medical Officers—can be, and are protected
against Small Pox by the simple expedient of re-vaccination. To come
down to a striking and quite recent experience; during the third week
in February of this year, a statement appeared in the Daily Press to
the effect that out of a staff of 43 nurses employed at the Mile End
'Infirmary, 35 were re-vaccinated and had not suffered from Small Pox,
while of the other 8 who were not re-vaccinated, 7 had already contracted
the disease. Such a statement was not likely to be accepted
without criticism and challenge, and thinking it would be a good test
case from a practical and common sense point of view, Dr. Acland
enquired into the facts, which were found to be as follows:—Early in
January, 1902, there were 40 nurses and 2 matrons on the staff of the
Mile End Infirmary, and one nurse on sick leave, a total of 43. Not
one of them had had Small Pox previously; of these 31 had been
re-vaccinated at various dates up to 2 years before the outbreak.
Four were re-vaccinated on January 28th and 29th (2 of them unsuccessfully).
None of these 35 contracted Small Pox. Of the remaining
8, one was away on sick leave, leaving 7, who all suffered from Small
Pax. Of these, 3 were not re-vaccinated, and the remaining 4 all
sickened with Small Pox in 2 days (2 cases), 3 days, and 6 days
respectively after vaccination. Thus these 4 cases were incubating
Small Pox at the time they were re-vaccinated, and though it may not
be strictly correct to say that none of the vaccinated cases suffered from
Small Pox, it is certain that none of the cases who were re-vaccinated
before infection, contracted the disease, and all the cases who suffered
from Small Pox were either unvaccinated or re-vaccinated only during
the incubation period of the disease I may here remark that vaccination
within a short time after exposure to the infection of Small Pox may be of
some use in mitigating the attack, but that if delayed until the incubation
period is advanced, it may be expected to exercise little or no influence on the
result.
A similar and very striking object lesson may be learnt from
the records of the Small Pox Hospitals of the Metropolitan Asylums