F. M. Turner 
485 
(c) On the other side it is often argued that the death-rate among the 
doubtful class is high, and corresponds closely with that among the uuvaccinated. 
Hence it is assumed that the majority of " doubtful " cases were probably unvac- 
cinated. I do not agree with the conclusion, for the high death-rate (higher than 
among the admittedly unvaccinated) may be due to the fact that in cases with 
very severe eruption it is impossible to be sure that a scar is present. 
It is noticeable that the above values are lower than any of those found by 
Macdonell for previous epidemics, as well as for those he obtained for the same 
epidemic in London. His figures for the latter were obtained before the M. A. B. 
Report for 1902 was published, and are subject to the drawback of including an 
undue proportion of deaths. I cannot explain this better than by quoting the 
article in the Tivies from which his figures were drawn. "Returns during the 
" progress of an outbreak have a serious drawback, which must be carefully borne 
" in mind. It is obvious that only completed cases can be dealt with, as the 
" result of those still under treatment is uncertain ; but since death usually takes 
" place at a comparatively early stage of the illness, the fatal cases are always in 
" advance of the recoveries The case mortality therefore always appears very 
" much higher during an outbreak than it really is. In the present instance it 
" is probably more than twice as high as it should be." 
The following two tables are copied from his paper : 
TABLE A. 
London, Cases admitted to M. A. B. Hospitals, and comjyleted to Recovery 
or Death, vp to November SOth, 1901*. 
Recoveries 
Deaths 
Totals 
Unvaccinated ... 
30 
60 
90 
Vaccinated 
195 
45 
240 
Totalw 
225 
105 
330 
?•= --6605 ±-0406. 
TABLE B. 
London, Cases admitted to M. A. B. Hospitals, and completed to 
Recovery or Death, up to the end of 1901. 
Recoveries 
Deaths 
T(jtals 
Unvaccinated ... 
96 
98 
194 
Vaccinated 
652 
108 
760 
Totals 
748 
206 
954 
r= --5779 ±-0311. 
* I have altered the sign of r, and the arrangement of the table to make it comparable with my own 
tables. 
