A.R. Urquhart, Henry Rayner
1902 The Lancet  
To the Editors of THE LANCET. ] SIRS,—The small-pox question, as discussed by you in your leading article in THE LANCET of March 8th, p. 678, carries my mind a long way back in my own experience. In 1863, very shortly after my appointment to be medical officer of Glasgow, we were confronted with pa a rising epidemic of small-pox which had to be met by in means largely extemporised and by a preventive staff-it not to speak of a very inchoate state of the local and general sanitary acts-very
more » ... ior to those now in operaal tion. Nevertheless, by diligent and specially organised J house-to-house vaccination and revaccination (taking this, t1: for the nonce, altogether out of the hands of the b, Poor-law authorities); by public disinfection (then freely it carried out at the public expense for the first time) ; by segregation of the sick and careful watching (as w far as was possible to us) of suspects ; we had the p satisfaction, not only of keeping down and ultimately rf extinguishing this particular epidemic, but of laying n the foundations of a preventive organisation which, b improved by experience, succeeded in keeping Glasgow p for a good many years absolutely free from small-pox. It e was apparent to us at that time, and was confirmed e later by Dr. J. B. Russell, that the most dangerous r cases from the sanitarian's point of view were not the I severe but the mild cases, and particularly those in which a the diagnosis was obscure and in which, after a brief premonitory fever and a few insignificant-looking spots, all the symptoms subsided, so that the patient was able to go about his ordinary occupation and perhaps never came to know what was the disease he had at all. I remember a case of this kind among what may be called the better ranks i (socially speaking) which occurred after I had ceased to be s medical officer of the city but which was carefully traced 1 out in detail by my successor, Dr. Russell. A gentleman connected with one of the most flourishing shops in the most shoppy street in Glasgow (Buchanan-street) came home from Paris with what was supposed to be a feverish cold. He sent for his private medical adviser, who arrived, prescribed, and left him under the impression above-mentioned, and did not (as I was informed) visit him again. Next day a few insignificant acne-like spots ! had appeared on the face, but all discomfort was gone and the patient regarded himself as quite well, taking no precautions whatever. To this single case, moving in the best society, I was credibly informed that from 12 to 20 cases subsequently were actually traced in different quarters ; and in all probability those so traced were only a fraction of the whole.
doi:10.1016/s0140-6736(01)82037-7 fatcat:bnfnuell3ba5vceregup5fkbiy