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It accompanied the clash of arms of the American armies in their
struggle for independence, and in their Civil and Spanish wars;
it claimed more victims than the battlefield in the ravages of the
Crimea; it formed the dark background to the triumphant marches
of the German army in 1870; it increased tenfold the horrors of
the siege of Paris; and plagued our warriors at Tel-el-Kebir.
Even during the late Great War no inconsiderable amount of smallpox
occurred amongst all the armies involved wherever conditions of
insanitation triumphed over the scrupulous efforts made to circumvent
them.
Smallpox outbreaks and epidemics have invariably been the call
of Nature to responsible authorities at home: "Put your house
in order"; personal municipal, and civic cleanliness has been
her unvarying demand, a demand which was couched in one striking
injunction by the prophet of old: "Wash and be clean."
Redruth
I remember 26 years ago there was an outbreak of smallpox at Redruth,
in Cornwall. The Press in all parts of the United Kingdom was immediately
supplied with exaggerated reports, and scares were created by public
vaccinators hundreds of miles away. I went down to investigate the
affair on my own account. There were altogether 44 cases; 84% occurred
in vaccinated persons.
One-fourth of the cases was located in "Trestrails Row,"
consisting of seven houses, each containing only two small low-roofed
rooms, and with no water connections. One midden privy, in the most
disgusting condition, accommodated the seven houses. One of these
hovels was occupied by no fewer than seven persons, all of whom
contracted smallpox, and out of the total of seven deaths three
occurred in this house.
Nearly another fourth of the cases was confined to Adelaide Road
and Raymond Road, where smallpox first appeared, the houses of which
were supplied with uncovered cesspits. Three cases occurred in Falmouth
Road, with one death which took place in a house closely hedged
in by foul middens, a manure heap, and a piggery.
Three more cases and one death occurred in the midst of similar
unsanitary conditions at Hockin's Court. Midden privies were the
order of the day, and the ultimate disposal of the sewage was primitive
to a degree. The smallpox rapidly played itself out, and then the
municipality corrected the conditions that had been the cause of
the outbreak.
Gloucester
I remember, too, the epidemic in Gloucester in 1895-6. I was in
and out of the smallpox houses throughout that visitation of nearly
2,000 cases. The echo of it is still heard among the ranks of Jennerian
followers, and always with the tragic whisper, "Gloucester
was an unvaccinated city!"
Never in all the history of professional scaremongering was such
a determined effort made to boost vaccination, and never a word
was uttered as to the shocking unsanitary conditions which produced
the tragedy. In fact, those conditions were persistently denied
by the officials who were responsible for them.
The smallpox was practically confined to the southern half of the
city, where there was no fall for the sewage.
The pipes had been hurriedly laid in this new district without
concrete base or cemented joints.
There was a drought that lasted months; the water supply ran short;
flushing of the sewers had to be discontinued, and the sewage pipes
became choked.
When, after the epidemic was over, investigation was made, the
pipes were found to be broken in all directions; in fact, the whole
district of -- for the most part -- crowded houses, many of them
back-to-back with no through ventilation, lay over what was nothing
more nor less than a huge cesspit.
The outlets for the sewer-gas consisted of street manholes, which
belched their poison into the atmosphere.
I traced the first case of smallpox in every street to the house
nearest to a manhole.
Wooden stoppers were made to close them down, but they had to be
used sparingly lest the sewer-gas should be driven into the houses.
Hundreds of the houses were drawing their water supply from shallow
wells, liable to contamination by constant leakage into them from
house drains; and the sewage-pipes in numerous instances ran under
the floors of the houses from the closets at the back to the street
in front.
Some of the houses had their toilets in the back kitchen. In one
street of 114 houses the latter were supplied with water declared
by the city surveyor to be contaminated with sewage from its source
to its delivery, and as it had not force enough to fill the flushing
tanks, the toilets were never flushed and always choked, the contents
being emptied periodically on to the small garden ground attached.
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