339
SMALL-POX.
Forty-eight cases were admitted for treatment-of these, 43 were males and 5 females. According to nationality there were :-
European
Chinese Indian
..Males 21; Females 1.
-18
4
"}
29
3
"
Filipino
1
*
43
5
Variety of Small- Pox.
The usual varieties were prevalent in the following proportion :-
Discrete.
Confluent.
Males-European,
15
Chinese,...
13
5
Indian,
3
0
Filipino,
I
0
32
10
Females-European,
1
Chinese.......
3
1
3.
N
Total.
35
12
Deaths.
The deaths numbered eight and were:
Europeans-Males,
Hæmorrhagic.
1
0
샤이아
f Confluent 4
Hæmorrhagic 1
Female, Chinese Male,
Confluent 1
Do.
1
Female,
Do.
1
ន
Vaccination and Small-Pox.
The days when the efficacy of vaccination as affording a means of protection against small-pox was questioned are practically past. It is universally conceded that vaccination is in the great majority of cases protective should, however, the vaccinated person be attacked by small-pox it has been proved (1) that the attack is comparatively miki, and (2) that mortality is much reduced. It must be remembered that sometimes an attack of small-pox may supervene on recent successful vaccination, but careful enquiry reveals that the disease was incubating when the vaccination was performed. In such a case both run through their regular course, but the attack of small-pox is generally mild and modified, and there is no tendency to a fatal issue. Should, however, the attack of small-pox be well established vaccination in the course of the disease, as well as after it, proves unsuccessful. This fact is used as a means of differential diagnosis when there is any doubt as to the case; if vaccination is successful the case is probably not small-pox. Some doubt has been recently thrown on this method of diagnosis in the medical papers, and cases have been brought forward shewing that vaccination may be successful after small-pox has begun. These exceptional cases were very few in number, and can scarcely be accepted as sufficient to overturn our own experience here, which is, that when small-pox is established vaccination proves unsuccessful.
Table I shows the condition as regards vaccination in relation to variety.