QUARANTINE AND SMALLPOX. 



231 



of small-pox here, clearly that is because the third condition has 

 never coincided with the other two. For we exhibit a full measure 

 of personal susceptibility, since, as I calculate, there are at present 

 in this city alone, at least 100,000 unvaccinated persons, reckoning 

 those only who are under 20 years of age ; while the specific 

 oontagium has been often introduced, and must continue to be 

 introduced from time to time in the future, in spite of the greatest 

 possible watchfulness at quarantine, and in spite of the arrest 

 of all but a very few undiscoverable cases. The outbreak of 

 1881 seems to me a conspicuous example of the absence of the third 

 •condition, for although there were then in the city, I reckon, not 

 less than 23,400 unvaccinated children under five years of age 

 alone, and although the contagium remained alive and active for 

 about eight months, yet no more than 154 persons are known to 

 have suffered out of a population of about 228,000. 



The outbreak occured in 1881 ; the district affected being the city and 

 suburbs of Sydney. The aggregate population (Census, 1881) was 

 224,211 ; the specific population of the city only (holding 103,379 people) 

 was 24,268. The natural and industrial conditions were markedly healthy 

 and the people were prosperous (birth-rate, 39*1) . The general sanitary 

 condition was bad ; the death-rate per 1000 living, from fever, cholera, 

 and diarrhoea, and the true infantile mortality, both reckoned on an average 

 of the 5 years 1876 — 80, were respectively 2*4 and 169 - 6. Also, vaccination 

 although gratuitous was voluntary, and the amount done by practising 

 physicians was admittedly insignificant ; but of the latter no record has 

 been kept. 



Table showing the births, the deaths under 1 year, and from 1 — 5 

 years ; the number of successful public vaccinations under 1 year and 

 from 1 — 5 years, and the total number of successful public vaccinations 

 at all ages ; in the city and suburbs of Sydney, for each of the five years 

 1876—80:— 



Year. 



Births. 



Deaths. 



Vaccinations. 







0—1 



1—5 



0—1 



1—5 



Total all 



ages. 



1876 



6368 



1082 



859 



308 



679 



1217 



1877 



6645 



1038 



500 



1079 



2928 



5236 



1878 



7158 



1241 



753 



151 



270 



518 



1879 



7861 



1206 



595 



222 



328 



649 



1880 



8354 



1606 



963 



141 



227 



457 



The Outbreak. — The first known case was discovered May 25, 1881 ; the 

 last February 19, 1882 ; the mode of introduction remained undiscovered. 

 The total number attacked was 154 ; the death-rate 25' 9 per cent. 



Method of Treatment : — Isolation and (voluntary) vaccination of all 

 members of infected households. 



In 'practice : — For the first three months the general administration was 

 chaotic, and there were mistakes of diagnosis (see contemporary non- 

 official records). From the Official Eeport issued in 1883 it appears that 

 it was believed that many cases were concealed during the first six 

 months, and were therefore not isolated; that in many other cases 



