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46
Small-pox.
In the year 1902, ten cases of small-pox occurred in
Twickenham. For eighteen years the disease was absent
from the district, but on April 22nd, 1920, I was asked to
see an adult female patient in consultation with one of the
local medical practitioners, and agreed with him that the
case was one of Small-pox. The onset of the disease was
on the 15th April, and the rash appeared on the 18th April.
The patient, a middle-aged woman, had been vaccinated in
infancy but not subsequently, and the scars were faintly
visible.
The nature of the illness had not been recognised and
the patient had moved freely about the district during the
first two days after the appearance of the eruption.
The source of the infection was obvious. The patient's
husband had an attack of what was supposed to be malaria
which commenced on March 25th, while he was in Spain
and was probably contracted in Barcelona. This illness
was not recognised as small-pox and he travelled from
Spain to his home in Twickenham without let or hindrance.
When seen by me on April 22nd, he had evidence of recent
fading scars and the distribution of these on the face, limbs
and body, together with the history, removed any doubt as
to his having suffered from recent small-pox.
The patient was immediately removed to the small
block at the Infectious Diseases Hospital, Whitton, which
is usually reserved for convalescent cases of scarlet fever,
and was treated there until recovery.
The immediate contacts were quarantined at home and
vaccinated at once. Full enquiries into the patient's movements
showed that she had mixed freely with a number of
persons and had been into several shops while the eruption
was present. Immediate notice of the occurrence of the