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"I was led to the conclusion that the cause in most cases was dirt, and that vaccination was powerless to prevent it. I found that where there was most overcrowding there small-pox was most prevalent. The worst case I have ever seen occurred three weeks after re-vaccination."--- Dr Allinson DR. T. B. ALLINSON AT HACKNEY (1883).

[Report by Dr. Airy in Supplement to 11th Annual Report of the Local Government Board.]

OUTBREAK OF SMALLPOX AT BOURNE BRIDGE.

"A. house, rented at £6, stands in a flat swampy meadow, liable to be flooded. It is approached by a causeway of faggots laid across the swamp. Two rooms on the ground floor, and two above. One of the lower rooms is a damp, cold, dirty room that serves as scullery, rubbish-hole, and slop sink. Slops are emptied at one corner of this room where a hollow has been excavated in the rough brick floor, communicating, by a large hole broken through the base of the wall, with a corresponding hollow in the mud outside, whence the filth soaks away through the surrounding grass and its own accumulated sediment. In this room nine persons slept! A. loose-made door opens directly into the shed where sheep, more or less diseased, were kept. The mother had been already attended for typhus and puerperal fever in this same house! A. cattle shed also adjoins the cottage. Eight persons had smallpox, and two died. Very defective drainage reported. The stinking carcasses of two sheep lay near the cottage at the time the small-pox was in the house."….not one of the inmates appears to have been unvaccinated!

CONDITION OF CAPETOWN.

WE have for some time past been hearing of the epidemic of smallpox in Capetown, and of the vigorous measures adopted to enforce vaccination and isolation, but we have heard little of the sanitary condition of the place. From an article in the Cape Times, however, we obtain the following information

"Capetown is buying its experience at a heavy price. Fifty thousand pounds spent on a reservoir that will not hold water is a lesson that should not .require to be repeated. Pestilence abounding (for we have it in many forms), the fruit of long-continued filth and neglect, scarcity of water, foul, unkempt, "unlovely" streets, seas of mud in the winter and hurricanes of dust in the summer— worst of all, a population ignorant as Arctic bears of sanitary principles, dead in a large proportion to the commonest instincts of decency. We have taken very busily to flushing, scouring, and quarantining, and making such atonement as is possible for past neglect and apathy. But too late; the retribution has come, as come it must, when ever the plain dictates of common sense and the laws of Nature are persistently violated. There is a very large element in the population of Capetown that exists only to propagate dirt, and in this they move and have their being. They make dirt as silkworms spin cocoons. They are dirty by instinct, dirty by habit, and, alas! dirty by necessity. With instinct, habit, and necessity constraining them, how can they be otherwise? Whole quarters of the town have for a long time been so abandoned to dirt, that only an earthquake could efface the evil effects on soil and atmosphere; and only if the earthquake should swallow up the inhabitants would there be some hope for these localities in the future. But let the truth be realised; a people born, bred, and educated in dirt will bear fruit after their kind. Spite of sanitary inspectors and municipal codes, they will be dirty; they will conquer all with dirt, and subdue the very sky to its influence. There is but one way, we believe, of overcoming this destructive element, and that is by a process of sap and mine. Habits must be changed. The dirt-loving must be made dirt-hating. There are elements in our population that are not easily impressed and even approached. But we decline to believe the thing impossible, and it ought to be tried. Capetown must go from bad to worse if sanitary regulations are not more strictly enforced; for its population is increasing, its open spaces are diminishing, and the foes to health are augmenting in proportion."

Vaccination Inquirer 1883. Vol 5, p15