For the past few years considerable attention
has been directed towards the outbreaks of smallpox
in various parts of England and Wales. These have
caused groat expense and inconvenience to the communities concerned, The type of disease has been
mild, differing in some points from the classical
type, and giving rise to a groat, deal of discussion
as to whether we are not encountering a different
Although in vaccination we have a prophylactic
remedy capable of stamping out smallpox, the laxity
with which our present vaccination laws are framed
has caused largo numbers of our population to be
unprotected, forming an apparently inexhaustible
reservoir which affords material for epidemics to recur.
These epidemics if left alone increase rapidly, may
become seasonal, and may even, in some cases, take
on an endemic character.
As an Assistant Medical Officer of Health for
Derby, I have been in touch with one of these outbreaks of smallpox, one which has now lasted some
four years and which has every appearance of continuing
In this thesis I propose to describe my experi_
experiences in connection with the outbreak, my
observations being based on nearly two thousand cases
of the disease. It shall be my endeavour to prove
the important fact that we are dealing with true smallpox. Further, as vaccination and smallpox are so
closely connected, I also propose to discuss some of
the problems arising with regard to the former.
1. A recent outbreak in Derby, of Smallpox (variola
minor) is described.
2. The cases have been shown to be predominantly
mild, but there has been a small number of severe
cases of the classical type.
3. The epidemiological features of the outbreak are
4. Clinical cases are given illustrating the out_
break. These show that the likeness to the major
disease is very marked.
5. The differences between "alastrim" `and variola
have been discussed. It has been shown that many
were non-existant in the outbreak.
6. Finally, "alastrim" and variola are one disease.
They differ only in severity.