London's Pulse: Medical Officer of Health reports 1848-1972

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Shoreditch 1859

[Report of the Medical Officer of Health for Shoreditch, Parish of St. Leonard]

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18
1 will conclude these observations with one remark as to the supposed
connection between the Thames and Cholera. It has been hotly contended
that the state of the river was itself capable of generating Cholera ; and
a fortiori, the disease once apparent on the stream, it would propagate
itself and spread with fearful rapidity from this congenial focus. Now I
call attention to the fact that last year, during the heats of July when the
river was extremely offensive, three several times was Cholera in a virulent
form imported from Hamburgh. The cases were admitted under my care
on board the Dreadnought. There the disease stopped. The conditions
necessary for its propagation were not there.
Small-Pox.—The universal prevalence of Small-Pox in an epidemic
form not only in this District, but over the Metropolis and many parts of
the country, is a circumstance that calls for the more serious attention
because it is, owing to the discovery of vaccination, the most preventible
of diseases. We have seen that 87 persons died of Small-Pox during the
year, and that 402 cases of this disease came under the Poor Law Medical
Officers. To the 87 deaths must be added several more which occurred
in the Small Pox Hospital. In many instances it is specially recorded
that the victims had not been vaccinated; in the majority of the remainder
I have no hesitation in saying that if vaccinated at all, the vaccine
disease had not been fully produced. The 402 cases reported are far
from representing the extent to which the disease has prevailed. The
great majority of these cases occurred in vaccinated persons ; and the
disease was much modified in severity in consequence. Under this
partial protection the deaths are not in so large a proportion as 1 in 4.
Many of the deaths occurred in private practice, so also certainly did a
corresponding number of cases of Small-Pox which recovered; without
pretending to precision, I think we may safely estimate the number of
inhabitants of all classes who took the Small-Pox during the recent
epidemic was more than 1000. From this we may form some feeble idea
of the ravages that this loathsome disease would have created had its
contagiousness and virulence not been checked by general vaccination.
It is in the highest degree probable that many hundreds if not thousands,
would have perished. But no consideration of thankfulness for escape
from greater evils ought to sway us to neglect the lesson of prudence
conveyed in the actual loss we hear endured. It is our duty to carry the
protection afforded by vaccination to the utmost extent.