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Smallpox comes to Melbourne




The World Health Organisation declared smallpox eradicated in 1979.

Smallpox had been a highly contagious disease that typically killed 30% of those who contracted it, although in the worst of its four forms, it was almost always fatal. It afflicted members of all social strata equally: across 18th-century Europe, "400,000 people died annually of smallpox, and one third of the survivors went blind."01

Its cause was still not broadly understood by the middle of the 19th century -- it was spread by inhaling the airborne variola virus, and its onset could be diagnosed by a sudden, high fever and characteristic rash. Unlike chicken pox, with which its early stages were frequently confused, even by experienced medical practitioners (as you will see), small-pox would almost always leave its indelible mark on a survivor's face. Even at its most benign, it left its victims permanently scarred and sometimes horribly disfigured. And in the middle of the nineteenth century, it was still quite a common and well-known threat, and -- justifiably -- was greatly feared.

So it would have been with no small measure of apprehensive dread that the good citizens of Melbourne would have opened their daily newspaper on November 28th, 1868, to read the following report:

We regret to learn that small-pox has made its appearance in this city. A seaman named Webster, from on board the ship Avonvale, which arrived from Foo-chow-foo [Fuzhou] on the 22nd inst, was admitted into the Melbourne Hospital on the 24th, and yesterday his complaint was found to be unmistakably smallpox. The hospital management communicated with the chief medical officer as soon as this discovery was made, and the man was removed last night to the hospital at the Immigration Depôt. All communication between the ship and the shore was cut off in the course of the day, and she will return to the quarantine station this morning.02

The Avonvale has sailed from Fuzhou, capital and one of the largest cities in China's Fujian Province, via Anyer (Anjer), a watering-point and rendezvous for trading convoys in the Sunda Strait, on the northwestern coast of Java, shown in the lithograph below that was engraved at about this time.

Anjer on the northwest coast of Java

Anyer (Anjer) on the northwest coast of Java, about 1870
1865-72 Lithograph by Abraham Salm
Tropenmuseum of the Royal Tropical Institute (KIT) of the Netherlands

Two crew members had died during the voyage, one of whom, according to the Chief Medical Officer's eventual report into the outbreak to the Victorian Central Board of Health, had "most probably died of small-pox".03

Whether because of genuine ignorance or as an attempt to maintain public calm, the nevertheless-sanguine temper of the remainder of the above news item from the “Argus” seems to have set the tone for much of the reporting of events that ensued over the course of the following months, as the disease took a stealthy hold across Melbourne:

It does not seem that this case need cause any alarm in the public mind, since the authorities have had early cognisance of the appearance of the disease, and have taken prompt measures to prevent its spread amongst the population. It is most fortunate, however, that the case turned up in the Melbourne Hospital and not in a private dwelling, where probably its true nature would not have been discovered until too late to isolate the patient.

During the course of the outbreak, which lasted for some six months, the news would give rise to far more concern, but every time it did, part of the report seemed to be calculated to encourage the belief that things weren't really that bad after all (or could easily have been much worse). Still, at the outset, discretion was wisely deemed to be the better part of valour:

It was intended, we believe, that seventy of the children from the Industrial Schools at Prince's-bridge should be sent down, on Tuesday next, to the Sanatorium, at Point Nepean. It is obvious, however, that such an arrangement, however desirable it might be in other circumstances, cannot now be carried out, as the barque Avonvale has just been sent back to quarantine there. The Sanatorium may be required by the crew, and of course the children could not with safety be sent there while there was danger of infection from small-pox to be apprehended.04

Arriving late to the party, Sydney-siders soon heard of the outbreak, and wisely decided not to risk awaiting any more conclusive diagnosis:

TELEGRAPHIC DESPATCHES.
(FROM OUR OWN CORRESPONDENTS.)
SYDNEY, WEDNESDAY.

Orders have been issued for the special observance of the sanitary laws on the arrival of any vessels from China, to prevent the introduction of smallpox.05

Quarantine Hospital Wards at Point Nepean

Quarantine Hospital Wards at Point Nepean
Five such double-storey barracks were built in 1858
Private collection

Diagnosed on a Friday, news of the disease's outbreak spread swiftly to even the (then) most remote settlements, such as Portland, where the following report appeared within a week:

THE INTRODUCTION OF SMALLPOX.

Some considerable excitement has arisen in Melbourne during the last day or two over the realisation of the fact that small-pox has really been introduced in our midst. On Saturday it became almost a general topic of conversation that the dreaded disease had broken out ... Mr William Webster, the chief mate of the barque Avonvale, from Foo-Chow-Foo, which arrived here on the 22nd inst., was admitted into the Melbourne Hospital on the 24th inst., and on Friday last it was ascertained by the medical authorities that his ailment was undoubtedly small-pox. On the discovery being made the patient was promptly transferred to the Immigration Hospital, Bourke street west, over which Dr McGaurin presides. He ascertained that it was a very bad case of small-pox, and on prosecuting his inquiries as to the origin of the disease, he found that two of the crew had died during the voyage, one of whom was the carpenter of the ship, and that the disease broke out shortly after the vessel left her port of departure. On ascertaining these facts, Dr McGaurin communicated them to the Chief Medical Officer, Dr McCrea, who at once vaccinated all on board and ordered the ship to be forthwith removed out of the river and sent to the quarantine station at the heads. The vessel left the river on Saturday afternoon. ... The conduct of the captain in passing his vessel without making the medical officer acquainted with the existence on board of so contagious a disease will form a subject for inquiry. The patient, at present under treatment in the Hospital, is in a very precarious position, and great care will have to be exercised to save his life.
06

Clearly spurred on by a desire to unload his cargo, take on more, and turn his vessel around for departure as expeditiously as possible, the captain of the Avonvale, William Ogilvie, left the quarantine station at the Heads and returned to anchor below the city, barely three weeks after the unfortunate Mr Webster had first fallen ill:


IN THE RIVER.
Avon Vale, barque, 307 tons, Wm. Ogilvie, Parbury Brothers.
07

... which would only have served to make the following report in the Hobart press (if true) all the more alarming to its readers:

LATER FROM THE COLONIES.
[BY ELECTRIC TELEGRAPH.]

(Per Greville and Co., Reuter's Agents.)

MELBOURNE, Saturday.

A third case of small-pox has occurred on board the barque Avonvale, a man belonging to which vessel has died here.
08


However, it was probably not true, or was more likely a confused reference to Webster's own illness -- an appendix to the the Health Department's "History of Smallpox in Australia, 1788-1908", published in 1914, concerning "Vessels Quarantined in Melbourne", states categorically that "No further cases occurred" on board the Avonvale after Webster's, and that the vessel was only detained in quarantine for a little less than two weeks (but nevertheless complied with the required three weeks from the initial detection of the disease, on November 20th). Within a matter of days, the Melbourne press was again prepared to suggest that every necessary step to contain the contamination had already been taken, in plenty of time, and the public could now afford to relax, and reflect on what a narrow miss they'd just had:

The alarm naturally consequent upon the late discovery of a case of smallpox in our midst may now be said to have subsided, and we think it right to publish more of the facts. On the 22nd of November there arrived here the ship Avonvale, from Foo-chow-foo. Among the crew who came ashore was William Webster, chief officer, who had become ill on the 20th. On the 24th he was, upon the order of the Government registrar of seamen, admitted to the Melbourne Hospital. On the 27th the case was reported to the chief medical officer's department as one of smallpox. Active and rigorous measures were at once taken. The sufferer was on the same day removed to the Immigration Depot hospital, and the ship in which he arrived was completely isolated, and next morning, the 28th, sent to the Quarantine station. On Friday last, Mr. Webster died. The rest of the crew have proved healthy, in quarantine; they have been vaccinated, and in the cases in which the vaccination proved unsuccessful, the operation has been performed over again. ... As all those now on board the ship Avonvale are reported to be perfectly healthy, she will be allowed to return to port after the expiration of twenty-one days from the date of Mr. Webster's first sickening -- viz., on Friday next.09



Fate would overtake Captain Ogilvie soon enough, however. He duly left Melbourne, but in August, 1871, together with all hands, he was presumed to have perished when the Avonvale disappeared in a China Sea typhoon after setting sail for Hong Kong from Newchwang [modern Yingkou].10


Hospitalized in Melbourne, the first mate, William Webster, had initially been placed into a small isolation room off a general ward in the Melbourne Hospital that was also occupied by a patient named Bissell, who was in the terminal stages of pulmonary tuberculosis. In a little over a week, the unfortunate seaman had succumbed, and by Monday, December 7th, the newspapers were obliged to report the following:

The man Webster, who was last week brought on shore from the ship Avon Vale, suffering from small-pox, died on Friday morning, and was buried on the same afternoon. His clothing was destroyed, and every precaution taken to prevent contagion.

... but once again in the same report, Pollyanna could not resist writing the optimistic footnote:

There need, therefore, be no fear of the spread of this fearful disease, which seemed to have been so suddenly and unexpectedly introduced into the midst of the city.11

However, within barely a few more days, there was already occasion to reconsider this benign assessment:

The reception of the poor fellow Webster, mate of the ship Avon Vale, while suffering from smallpox, has not proved so harmless an event as was hoped and believed. During the short time he was in the Melbourne Hospital he occupied a bed in a small room where another patient, named Bissell, had already been placed; and upon his removal this patient and the nurses were vaccinated. But, in spite of every precaution, Bissell caught the infection, and yesterday morning exhibited such unmistakeable evidences of the disease as to cause his immediate removal. It is believed that the preventive measures adopted would have been successful in the case of a person having any strength of constitution remaining, but this poor fellow was in the last stage of consumption, and had no vitality in him to resist the smallest attack. His removal having been so promptly insisted upon, and the room he occupied being entirely independent of the larger wards, it is hoped that no further outbreak will follow. Every possible measure to secure this has been adopted, and very strict watch will be kept by the medical staff in order to detect the slightest symptom that may manifest itself.12

The unfortunate Bissell was already dead by the time the above article was published, but his death was not attributed to smallpox, “although the disease was unmistakably present”; rather, he was said to have died from an acute attack of diarrhoea, a common complication of the terminal stages of the consumption for which he had originally been hospitalized. As had already become the usual pattern, however, the problem was deemed to be in the very best of hands, and in all likelihood had already been contained:

The rooms occupied by Bissell in the hospital and in the immigration buildings were thoroughly fumigated yesterday, under the direction of the chief medical officer, Dr. McCrea, and the clothing of the deceased patient burned. In addition to these precautions, all the persons who came in contact in any way with the patient were vaccinated, and there is every reason to believe that the disease will not extend further.13

But by the weekend, there was every reason to believe that this was not in fact the case:

We regret to be informed that a third case of smallpox has occurred in this city. The person attacked is a girl who lived in the neighbourhood of the Immigration Hospital, in which the two poor fellows, Webster and Bessell, died lately -- the former from this disease, and the latter acute diarrhoea, while labouring under an attack of smallpox.14

The victim in this case was a 17-year-old girl who, although she was employed at -- and presumably was also a resident of -- East Melbourne, had visited her family who lived in a right-of-way off Little Bourke Street, less than 100 meters from the Immigration Hospital, on December 3rd. There was some room for debate now, however, as to whether she was suffering from smallpox or “only” chicken-pox, which provided some opportunity for further reflection on the wisdom of treating highly contagious and potentially fatal diseases in the centre of an over-crowded, already-polluted city:

The recent removal of small-pox cases from the Melbourne Hospital to the Immigrant Depot Hospital, in Bourke-street west, has occasioned a great deal of remark as to ... the fitness of the latter institution for the reception of such cases. It was regarded as a strong argument against the practice, that both Webster and Bessell died so soon after their change of place, and the belief that a third case had occurred in the immediate neighbourhood was taken as additional confirmation of the objection. Happily, it has proved that the impression as to a third person being attacked by so dreaded a disease was erroneous, the case proving one of chicken-pox, and being entirely independent of residence near the death-place of the two unfortunate men. This, however, is not sufficient to allay the anxiety naturally felt by the people living in the locality as to future dangers which already seem to threaten them. As an institution for the reception of immigrants suffering from accident or sickness of a character not contagious, the Depot Hospital answers every purpose; but as a provision against possible emergency, such as we have already alluded to, it is altogether inadequate and unfitted. The building stands in a closely populated neighbourhood, having a narrow right of-way, crowded with poor and not too cleanly people, running along its entire length, and abutting upon others of an equally confined and unhealthy character. Besides this, it has no considerable elevation, and the wards which would have to be used if many cases occurred, are on the ground floor, low pitched, and not capable of thorough ventilation. These circumstances considered, it is clear that the place is such an one as should not be used for such purposes, or relied upon in such instances. For the present we are inclined to believe all danger past, but in the future it will behove the authorities to make such provision for casualties of this kind as will prevent even the chance of contagious disease being introduced into a neighbourhood thronged with poor people, and in a condition highly favourable to the spread of any infection that may be brought into it.15

By the following day, that third patient had been completely exonerated, although in retrospect she would also eventually be assessed as having suffered a "mild" case of smallpox, from which she was able to recover. She was, however, replaced with another from the same vicinity, and this was being reported as follows:

We regret to learn that a case of small-pox was discovered yesterday afternoon in Little Bourke-street, and the sufferer was at once conveyed to the hospital at the Immigration Depôt. She is a married woman, about thirty years of age, who was residing with her father in the right-of-way behind the Immigration Hospital, her husband being in New Zealand. Considerable anxiety on the subject has been shown in the neighbourhood of the hospital. In this case there is no doubt, we believe, as to the character of the woman's malady, and prudential considerations suggest that steps should at once be taken for the isolation of all such cases. The Immigration Hospital is in a most improper situation to be used for small-pox patients.16

You might notice a rather more insistent tone in the last sentence, when compared to the reasoned argument of the report from only the previous day. From our safe, sanitary distance, it is perhaps difficult to conceive of the deplorable condition of the booming city's limited and now sorely-taxed public health infrastructure, but it can perhaps be glimpsed from another report on the following page of the same issue -- the City Council had initiated legal proceedings against the Melbourne Hospital under the provisions of the Public Health Amendment Act for allowing its cesspools to overflow into the street. The Hospital's defence was that the escaping liquid had been "found to be innocuous"; to which (counsel for) the Council responded that the Act specifically prohibited any leakage or overflow from cesspools whatsoever.17


THE HOSPITALS


MELBOURNE HOSPITAL

Melbourne Hospital in 1862

Melbourne Hospital, Lonsdale Street, in 1862
Lithograph by Nicholas Chevalier (1828-1902)
Courtesy RMH Archives

Founded in 1848, the Melbourne Hospital (not proclaimed “Royal” until 1935) was then located in Lonsdale Street, east of Swanston Street. By 1867, it was attracting qualified accolades like the following: "... the Melbourne Hospital is now equal, in many respects, if not in every respect, to some of the best institutions of the same description in Europe and America, notwithstanding its unsuitable site, and defective sewerage. ... Each ward is lighted by six windows on either side; and two at the end corresponding to that at which an entrance is effected. ... The sanitary arrangements have been made on the plan of the English Sanitary Commission and in accordance with the views of Miss Nightingale."18

Melbourne Hospital circa 1870

Melbourne Hospital circa 1870
1865-72 Lithograph by Abraham Salm
Courtesy RMH Archives



THE IMMIGRATION DEPOT

The Immigration Depot, on the other hand, was located on the site of a former abattoir. As an ad-hoc response to the crisis in immigrant numbers of 1852-3 that accompanied Henry Hadden's arrival, "assisted immigrants were channelled through immigration depots, where prospective employers could hire them. In the crisis days of the 1850s, the Victorian Government established immigration depots at Geelong, Portland and Port Fairy, possibly to encourage direct immigration of labourers and servants in rural areas away from the goldfields. ... The government established two immigrants’ homes in Melbourne in 1852. One was in a converted abattoir on Batman’s Hill (Spencer St), the other was at Princes Bridge."19 The other notable response to the crisis, of course, was "Canvas Town", stretching from Princes Bridge for as far as the eye could see down St Kilda Road.

South-west quarter of Melbourne in 1839

Detail from "A plan of Melbourne Port Phillip"
Photo-lithograph by H.J. Green Govt Printer Melbourne 1937
from original engraving publ R. Clint, Sydney, 1839
Courtesy State Library Victoria

The Immigration Depot and its attached Hospital were set back from the Yarra River at the south-western end of the city: “Queens Wharf, in front of the Customs House, was the river port around the swing basin. Private wharves were built along the river between King and Spencer Streets. The Government Immigration Depot was about one block to the north”20, and later publications referred to its Hospital as fronting onto Bourke Street west (in what is shown as block XVI on the above map), in an area which in those days was still known as “Batman's Swamp”. Inevitably, accommodation for other itinerants soon sprang up around it, in the form of boarding houses.


Immigration depot waiting room, 1867

Detail from "ENGAGING SERVANTS AT THE IMMIGRATION DEPOT, MELBOURNE", 1869
Wood engraving by Frederick Grosse (1828-1894)
from original engraving, publ E. & D. Syme, Melbourne, 1867

IMMIGRATION DEPOT.

One of the institutions of Victoria is the Immigration Depot. Here all the single females who arrive in the colony from Great Britain in search of employment, and who have no friends to stay with on their arrival, are housed until such time as they can meet with situations. Immediately on arriving in the port they are taken to the depot, and are allowed several days for washing their clothes and otherwise making themselves presentable to visitors. ... The room is listed as a dining-room and sitting-room by the women. On hiring days it is devoted to the accommodation of the visitors, and the hiring takes place in it. On these occasions, the scene is often very busy and animated. The announcement of a large number of arrivals caused a corresponding number of applications for servants, and the demand generally being in excess of the supply, the women readily obtain engagements. ... Every care is taken in providing for the comfort of the women during the time they are at the depot. ... The entire place is kept scrupulously clean, and reflects great credit upon Mrs O'Connor, the matron, who has charge of the establishment.21


The Immigration Hospital remained in use for smallpox quarantine until January 19th, 1869, when all its patients in isolation were moved to a special building at Royal Park.




By the following day, however (Christmas Eve), opinions regarding both “the character of the woman's malady” and the appropriateness of the Immigration Depot Hospital as a “situation to be used for small-pox patients” had clearly undergone some revision:

We are glad to learn that Dr. McCrea, the chief medical officer, is decidedly of [the] opinion that the case reported yesterday as one of small-pox is really one of chicken-pox. The disease is so little known in this colony that the appearance which it presents may have deceived those who first saw it, but Dr. McCrea's experience has been extensive, and he has no doubt on the subject. We also learn that everything has been done which experience suggests to prevent infection, and that the Immigration Depot Hospital, so far from being an improper place for such cases, is well adapted for their treatment. It will allay the fears of the neighbours when they know that, in Dr. McCrea's opinion, there is not the slightest danger of infection, even in small-pox cases, excepting to those who come immediately and closely into contact with the patient.22

In this as in many subsequent cases, Dr McCrea would insist on the accuracy of his diagnosis of chicken-pox rather than smallpox. Often wrong throughout this crisis but never in doubt, his defence of the adequacy of the Immigration Depot Hospital is perhaps harder to understand, unless it was based on the faulty assumption that there would be little or no uncontrolled traffic and commerce between its inhabitants and those in its immediate vicinity, which was decidedly not the case.

Dr William McCrea

As already [foot]noted in a previous installment of this story, Dr William McCrea, the Chief Medical Officer, had been one of the Castlemaine goldfield's 136 "doctors" in the early 1850s: "Described as tall, wiry and well built, William McCrea (1814-1899) was born in Ireland in 1814. His father had died before William was two years old and at 13 he was apprenticed to his uncle, a medical practitioner in London. He spent sixteen years as a naval surgeon, and after his arrival in Melbourne he was sent to Forest Creek diggings at Castlemaine as surgeon, coroner and magistrate. As Victoria's first chief health officer, he was chairman of the newly established Central Board of Health ... among his many duties, he had charge of inmates in the Colonial Hospital, the Orphan Asylum and Lunatic Asylum and the Immigrants' Home."23

As the Chief Medical Officer, appointed to head the Central Board of Health that had been created in 1855, he was characterised as "a medical man and sanitarian of the old school without precise knowledge of the origins and spread of contagious diseases provided by germ theory and later scientific discoveries."24

His record during the smallpox scare of 1868-9 perhaps does not represent him in his best light, other than demonstrating an ability to withstand criticism from his professional colleagues on the one hand, and on the other, to eventually admit that he may have made a mistake or two along the way; but Victoria clearly owes him a considerable debt of gratitude for the many other achievements of his career in public administration, as his entry in the "Australian Dictionary of Biography" illustrates: "... in 1853 McCrea was appointed head of the Medical Department and as Victoria's first chief health officer was chairman of the newly-established Central Board of Health. He was an excellent administrator, and with naval discipline was firm but fair with his staff. He held these appointments for twenty-five years and firmly founded Victoria's health services. ... He was vitally concerned with the investigation and control of the epidemics of typhoid, dysentery, scarlet fever and diphtheria in Victoria. In Melbourne the establishment of the Yan Yean water supply, the application of sanitary reform and the opening of the Queen's Memorial Infectious Diseases Hospital were highlights of his term and reflect great credit on his administration. ... He also served on the Police Superannuation Board and the committee of the Austin Hospital for Invalids."25

Reporting to the Colonial Secretary, the Chief Medical Officer and the Medical Officers in Melbourne became responsible for immigrants "from the time of their landing until their departure from the Immigration Depot". They were also responsible for the police, and for officers and prisoners in gaols and stockades. In seaport towns and on the goldfields they were responsible for immigrants, police, military, prisoners and the gold commission.

Up until 1855, quarantine had been a responsibility of a separately titled Health Officer. As Superintendent of the Sanitary Station which had been established in 1852 at Ticonderoga Bay, Point Nepean, and which was transferred to Queenscliff in 1853, the Health Officer was ordered to board every inbound ship in order to determine the health of its passengers and crew, "and where necessary to place the ship in quarantine." If the function continued to exist after 1855, exactly how the Avonvale managed to evade such an interception is no longer clear, although the same source for the above list of duties outlines some of the other functions associated with the subsequent administration of Public Health to specifically include quarantine, as well as the following:

  • the control and prevention of infectious and contagious diseases (including quarantine)
  • establishing and enforcing standards of proper sanitation including waste disposal and collection and prevention of pollution
  • establishing and enforcing standards for public buildings and dwelling houses and for the prevention of fires
  • registration and control of boarding houses and other accommodation venues and of premises where food was consumed
  • infant welfare and the vaccination, later immunisation, of children
  • administration of municipal or district hospitals
  • registration of private hospitals
  • care and treatment of patients suffering from tuberculosis, or cancer
  • registration of health care professionals such as doctors, dentists, pharmacists, opticians, optometrists and dietitians.26

So apart from the sheer breadth of the scope of his portfolio, which in fact extended even further to a number of other, less obviously-related areas in addition to the above, and the resulting possibility that some aspects of it might therefore have received less than their due amount of attention, all of the necessary authority for the management of this outbreak would certainly appear to have been concentrated in the right place, and able administrator that he was, McCrea was undoubtedly the man for the times. Nevertheless, it was perhaps for this reason that in this area, the responsibilities of the Chief Secretary's Department changed slightly over time, and as a result, "From the 1850's the municipalities ... also had a very significant role in the administration of many of the public health functions."27

          (Meanwhile, we've got smallpox going on out here, remember!)

To further reassure the reading public, the "Argus" of Monday, December 28th,repeated the news that this substitute third victim had been declared completely out of danger, and once again (in case you missed it the first time), had been found to be “only” suffering from chicken-pox:

We are glad to learn that Mrs Blair, who was believed at first to have been suffering from small-pox, but who subsequently was only found to be labouring under an attack of chicken-pox, is going on favourably. No other case has been reported.28

But we don't get too far into the New Year before the subject is back in the news, with the reporting (and hospitalization) of yet another person initially thought to be suffering from small-pox:

Not a little excitement has been felt by the inhabitants of the numerous dwellings in the vicinity of the Immigrants' Depot Hospital, Little Bourke-street, in consequence of the impression that several cases of small-pox have, within the last few weeks, been received and treated at that institution. This matter has been so pressed upon us that we have again inquired into it. It appears that the feeling, and all the fears to which it has given rise, are entirely without reason, no case of small-pox having occurred in the city since that of Bissell, who was carried off by dysentery. What has really happened is that several persons have been attacked by chicken pox, and, to remove all cause of apprehension, have been removed to the hospital and treated there. On Sunday a case of supposed small-pox was reported to Dr. McCrea, who at once ordered its removal to this place. It proved, however, on examination yesterday morning, to have developed into a confirmed case of measles, and nothing more.29

In a matter of days, dissenting voices within the medical establishment were continuing to insist on the inappropriateness of the Immigration Depot Hospital for treating these cases, and had convinced the City Council to direct any further suspected victims elsewhere:

... Yesterday several members of the Health Committee paid the locality a visit, and made inquiries as to the four cases now under treatment there. In consequence of what was then learned, they resolved to wait upon the Chief Secretary, and request the removal of these cases to the Royal-park, and the abandonment of the present building as an hospital. The ... committee, headed by the mayor, met the Chief Secretary, and Dr. McCrea, the chief medical officer. It was pointed out that a great deal of alarm existed amongst the inhabitants of the neighbourhood, who believed that the cases were small-pox, and suggested that the easiest and most proper way of dispelling that alarm was to remove the patients out of the way of the population. The committee also expressed their decided opinion that the building was no place for the treatment of any infectious disease, and upon that ground asked that it might be discontinued as an hospital.

Dr. McCrea asserted most positively that the alarm ... was entirely without cause, the cases being really cases of chicken-pox, which had also appeared in Sandridge and in various parts of Melbourne. The present place was as fitted for the treatment of such cases as any could be, and even for small-pox cases, if they were not numerous. He did not think it would be right to incur the expense of the proposed removal, in order to satisfy the fancies of people who had no cause whatever for alarm. A conversation followed in which this idea was combatted, and it was ultimately resolved that ... any future cases that might occur should be taken at once to the premises previously occupied for a similar purpose at the Royal-park, or to Melbourne Hospital.30

Despite these purposefully reassuring public utterances, however, Melbourne's medical fraternity were far from unanimous in their views of exactly how much risk the public were really being exposed to. It may or may not have been well known across the entire profession, but the public at least had certainly not been told that to this date (January 7th, 1869), at least a dozen people had developed symptoms of the disease, and many more would follow. Most of these were in the vicinity of the Immigration Hospital, but also included were a number in the outlying village of Greensborough, where, as early as December 10th, a 16-year-old male had shown the first symptoms. He had spent half an hour earlier that month in the very house "in a right-of-way off Little Bourke Street" where the first local case after Bissell, the 17-year-old girl, had been diagnosed, only 100 meters from the Immigration Hospital. Before the end of January, 1869, he would infect a further sixteen victims -- two of whom died in early February -- in his own and two other households within a 360-meter radius in Greensborough.

The following report suggests the turmoil that prevailed within the medical community as it struggled to confront (or even evaluate) the perceived threat. It is also possible to conclude that Dr McCrea's opinion might not have been held in universally high esteem by all members of the profession:

THE SMALL-POX IN WEST MELBOURNE.

On Saturday, Mr. W. Crooke, Mr. C. Stewart, Mr. F. Lloyd, Mr. J. De La Roche Bragge (health officer of Hawthorn), Mr. Wm. Gregory (health officer of Richmond), and Mr. G. Moore, waited upon the Chief Secretary relative to the patients at the Immigration Hospital, who were stated by the chief medical officer to be suffering from chicken pox, and by others to be suffering from small-pox.

Mr. Stewart stated that on the previous evening the members of the Medical Association had discussed the subject, and that morning some of the members had visited the hospital, and arrived at the conclusion, after an examination of the patients, that the disease was small-pox. Some of the gentlemen had had experience of the disease in England, and their opinion was of some value.

Mr. Crooke observed that he had had some experience in the treatment of smallpox, and he had satisfied himself that the patients now at the Immigration Hospital were suffering from that disease. He had told this to Dr. McCrea on Thursday, but that gentleman still adhered to his own opinion, which he said was fortified by that of other doctors. The Immigration Hospital was wholly unsuited for the treatment of the disease, for there were two tons of nightsoil within a few feet of the hospital.

Mr. McCulloch observed that the chief medical officer held a different opinion about the disease to that offered by the deputation, and he had given his opinion so late as that morning. The Government must be guided in such a case by the opinion of their officers, but he would appoint a commission that day to examine into the subject. He had already ordered that no new patients should be sent to the hospital, but that any new cases should be sent to the Royal-park. Mr. Crooke remarked that the medical men might be said to be interested even on selfish grounds in preventing the spread of the disease, for there were now comparatively few of the profession in Melbourne ...

Some further conversation occurred relative to the composition of the commission, Mr. McCulloch remarking that it would, perhaps, be advisable to appoint none who had already expressed an opinion. The deputation then withdrew; and soon afterwards Mr. McCulloch appointed ... a commission to inquire into the subject.

... The commission, consisting of Dr. McCrea (chairman), Drs. Barker, Motherwell, and Thomas, and Messrs. Pugh, James, Crooke, and Stewart, visited the hospital at four o'clock on the same day, and the patients having been examined,

  • Drs. McCrea, Motherwell, and Barker, and Mr. Pugh were of opinion that the disease was not small-pox;
  • Dr. Thomas, and Messrs. Crooke and Stewart thought that it was small-pox; and
  • Mr. James was of opinion that three of the four cases were not small-pox, and that one of them might be a case of small-pox.

There was also present Dr. Helm, of Trinity College, Dublin, and M.A. of Cambridge, who has lately arrived in the colony, and who, having been medical officer in charge of Rugby School, where he has had abundant opportunities of examining cases of chicken-pox, ... pronounced them all decided cases of chicken-pox. The patients are at present going on very well, and no further cases have occurred. A building has been prepared in the Royal-park for the reception of any new cases, should they occur.31

What was a lay reader to think?

The deferential weight that was accorded to the opinion of the "lately arrived" Dr Helm shows how quickly the cultural cringe had taken hold of early colonial decision-making, although it seems somewhat at odds with the need to complete the preparation of the separate building at Royal Park for any further cases that might have arisen.

A satirical early view of inoculation

"The Cow-Pock—or—the Wonderful Effects of the New Inoculation!" (1802)
Colour engraving by by James Gillray (1756–1815)
US Library of Congress, Prints & Photographs Division, LC-USZC4-3147

The editor of the “Argus” was finally obliged to side with the dissenters, and would appear to have had his editorial column written by one or more of them on the following Saturday, judging by diagnostic authorities that were cited and the writer's implied familiarity with the condition of the patients who had been hospitalized up to that point:

The arrival in the colony of a vessel bringing a case of real variola, the death of the patient suffering from this disease, and the subsequent occurrence of another fatal case, ... not unnaturally led to the belief that the second case was the result of contagion, and that this serious affection had been certainly introduced into the colony. As a matter of policy it might have been unadvisable to allay public apprehension by encouraging the belief that the other cases following upon these two were chicken pox, and not small-pox ... Pure varicella, or simple chicken-pox, however, is an altogether different affection from that which has for the last six weeks been occurring in West Melbourne, and of which there are now several very marked examples in the Immigration Hospital in Bourke-street west. Two of these which are now convalescent exhibit palpable evidences of true small-pox; another case at the ninth day of progress is singularly illustrative to the same effect, and the case of an elderly woman ... appears not unlikely to become a very striking illustration of the confluent form of the disease.

It can hardly be supposed that the official information ... that all the cases following upon that of Webster ... were cases of chicken-pox, was due to a mis-apprehension of the real nature of the disease, but that it was given with the not unpardonable desire to repress in the public mind that reasonable apprehension which arises from the knowledge of there being in a thickly populated community an infectious and terribly fatal disease, hitherto virtually unknown among us. ... true chicken-pox appears under conditions very different from those which have been observed in connexion with the present outbreak ... Dr. West, On the Diseases of Infancy and Childhood, says:- "Varicella (chicken-pox) is almost exclusively a disease of childhood ..." Now, in all the cases which have occurred in West Melbourne, the subjects have been adults, and not children. ... Sir Thomas Watson ... says also, "The disorder is almost peculiar to infants and children of tender years, The eruption is preceded by little or no premonitory fever, commencing usually on the shoulders, neck, and breast, affecting almost always the scalp, but sparing very much the face, which in small-pox never escapes." In the case just referred to, ... now in the Immigration Hospital, the face is one mass of eruption ...

The truth is that the disease ... is modified small-pox, but though modified, still absolutely and certainly small-pox ... This truth being recognised, it remains to point out the imperative necessity of isolating all cases of the disease ... The place until now selected for the reception of the patients suffering from small-pox is eminently unsuited for the purpose. It has at the back of it a thickly-crowded neighbourhood, in which are to be found all the conditions favourable for encouraging the spread of any epidemic disease. Villainous dwelling-houses, ill-ventilated, worse drained, and abominably crowded, simmer in continual filth in the north-western quarter of this city. The authorities have, so far, no doubt, done all that it is possible to do in the way of prophylactic measures; but the removal of all future incipient cases to a perfectly isolated locality is in future imperatively necessary, and to ignore any longer the no doubt alarming truth that real small-pox is prevalent in Melbourne, would be worse than an act of folly, and tantamount to a crime against the whole population, which would become endangered.32


The city into the midst of which this disease had been introduced was not today's public-health poster-boy, either, but rather was a chaotic jumble of poorly-formed streets with negligible drainage, no sanitary services or running water, and one which in some areas saw some of the young colony's first (and worst) most crowded, makeshift slum housing: “before the advent of the night or pan man every building had a pit toilet dug into the ground out the back, or else people (or their servants) emptied their pans and buckets into communal cesspools. If they were extra slack or disgusting, it might be a nearby vacant allotment.”33

This prompted the following rebuttal (even lengthier in its original form) by the Chief Medical Officer, Dr McCrea, in the following Monday morning's newspaper, although the public can hardly have been reassured by the variety and the equivocal nature of the opinions voiced regarding the disease by the members of the commission that had been previously appointed by the government:

SMALL-POX OR CHICKEN-POX?

TO THE EDITOR OF THE ARGUS.

Sir, -- I regret extremely that you should have thought proper to insert an article in your Saturday's issue affirming, unhesitatingly, that the disease under which the four patients at the Immigration Hospital are now suffering is unmitigated small-pox. Such a dogmatic statement, coming from any individual whose experience of the disease is not greater than most others, and not anything like so great as my own, could do nothing but harm, when attended with the prominence attached to a leader in your columns. Had the writer of the article seen me before the publication I do not think he would have ventured either to make some of the positive assertions contained in it, or to arrive at so confident a conclusion. ... The writer of your article quotes Dr. West, Drs. Maunsell and Evanson, and Sir Thomas Watson, in support of his opinion, that varicella is exclusively a disease of childhood; but he does not add that Sir Thomas Watson states, "Willan has, however, described one unambiguous example of it in a gentleman thirty years old; and another genuine instance was seen by Dr. Gregory, at the Small-pox Hospital, in the person of an adult female."

Dr. Plummer, of Sandridge, has handed me a memorandum, a copy of which I subjoin, showing that the disease commenced at Sandridge on the 10th November, 1868, eleven days before the case of small-pox in the mate of the Avon Vale was reported to me in the Melbourne Hospital, and five days before the Avon Vale arrived in the colony. Many of the cases seen by Dr. Plummer were adults ...

The next case was that of a female adult, who was living as servant in a family in Burlington-terrace, East Melbourne. There was scarlatina in the house, and the girl was taken ill of this disease on Thursday, the 10th December, the eruption appearing on the 13th. She was removed to her mother's house on the 15th, and then on that day the eruption of chicken-pox began to come out ... This girl had never been nearer the Immigration Hospital than East Melbourne since the mate of the Avon Vale was taken to it on the 27th November.34 She was discharged cured on the 27th December.

On the 23rd December a case of supposed small-pox was reported by the police to have occurred at Greenborough about a week before, in an adult named Limner. Subsequently the father and the younger brother of the same family were attacked by the same disease. They were visited, and examined by Mr. Bleeck, of Heidelberg, who pronounced them cases of undoubted chicken pox. ...

Urged by the prominence that the question has obtained before the public, the Government on Saturday appointed a commission ... to act with me in the investigation of the disease. They met at the hospital at four p.m., and after seeing the patients, Mr. Stewart, Mr. Crooke, and Dr. Thomas came to the conclusion that the cases were small-pox; Mr. James thought three of the cases were chicken-pox, and the fourth small-pox; whilst Dr. Motherwell, Dr Barker, Mr. Pugh, and myself, were of opinion that the cases were chicken-pox. Mr. James on this occasion brought with him Dr. Helm (a gentleman who has come to this colony for his health), who from his high culture and standing, and from his having had unusual opportunities of studying both diseases, whilst medical officer of Rugby School, is entitled to have some weight attached to his opinion. Dr. Helm ... at my request has written a report on them ...

If the writer of the article in The Argus had seen me, he would have known that although my opinion is very decided that the cases are chicken-pox, I have taken all the precautions necessary had they been cases of small-pox. The patients were at once removed to the Immigration Hospital; their clothes and bedding were disinfected; their houses were cleansed and fumigated with sulphurous acid; and the inhabitants of their houses, and those of all the neighbouring houses, were vaccinated. With regard to the fitness of the Immigration Hospital for receiving these patients, every one is in a separate apartment, well ventilated, and containing each above 1,200 cubic feet of air. The hospital is surrounded by a yard wall, and no patient is within fifty feet of any of the neighbouring houses. ... Had the disease spread, or had I been mistaken in my opinion as to its character, I had a building in reserve, in the Royal-park, perfectly isolated, to which the patients could be removed in two hours at any time.

I am, Sir, your obedient servant,

Wm. McCrea, Esq., M.D., &c,
Chief Medical Officer.

Melbourne, Jan. 1035


Physician's pocket vaccinator, ca.1880

Late 19th-century capped brass vaccinator
University of Melbourne Medical Museum
1994 AMA donation: Image MHM03374 Series 35


The “Argus” was nevertheless not going to take Dr McCrea's version without putting up a significant argument of its own, providing a detailed rebuttal of his main points, and declaring that "several forms of chicken-pox ... are now ... very properly regarded as modified varieties of small-pox. But because they do not answer in all particulars to the tests by which, what Dr. McCrea would probably term 'unmitigated' small-pox is to be diagnosed, they are not therefore to be confounded with a very mild and comparatively harmless disease. ... Dr. McCrea will perceive that no imputation of blame has been alleged by us to rest upon him in respect of the measures necessary to be taken to prevent the spread of the epidemic, so far as these can be accomplished under existing circumstances. But ... the Immigration Hospital, with numbers of persons passing in and out of it, is very likely to become a means of transmitting the disease in all directions, and a more isolated position, with stricter prohibition as to exit and entry, would, at any rate, be more reassuring to those whose fears are not unnaturally just now in the ascendant."36:

As the following report shows, at least the City Council had taken note, and, having dusted off the rule book, was beginning to lay down the law to the colonial government regarding the fitness and location of the buildings for the purposes to which they were being applied:

CITY COUNCIL.
WEEKLY MEETING.
-- Monday, Jan. 11.

SMALL-POX IN THE CITY.

Councillor M'Pherson brought up a report from the Health Committee, informing the council that the committee having learned that several cases of sickness resembling small-pox had appeared in a lane called Shamrock-alley, adjacent to the house to which two persons suffering from small-pox were recently removed, and that considerable apprehension was consequently created in the neighbourhood, the committee had caused the lane to be cleansed and sluiced with carbolic acid, and had also caused stone sulphur to be distributed to the householders for the purpose of its being burned in the houses: that the committee had an interview with the hon. the Chief Secretary and the chief medical officer, and been assured that no new cases should be taken to the temporary hospital, but (should any arise) to the Royal-park. Also, submitting a report of the circumstances as prepared and furnished by the town clerk to the hon. the Chief Secretary, and to the president of the Central Board of Health.

Councillor Butters remarked that as the Immigration Depot Hospital was in a low-lying part of the city, and not far from Batman's Swamp, where the drainage was bad, the Health Committee might fairly take into consideration the desirability of having the depot removed. The Government having a building in the Royal-park might properly be asked to send the immigrants there, in order to guard against the spread of epidemic diseases. The germs of the disease might often be latent in the immigrants at the depot without it being known in the ship they had left that they were affected, and it was very desirable that steps should be taken to prevent the spread of disease in such a locality.

Alderman Cohen said ... he was quite of [the] opinion that the Immigration Depot Hospital should be removed from Bourke-street west to the Royal-park, or some open place where the disease could not spread.

Alderman Wragge thought that the Government should be called upon to place no patients in a building within the city unless a regularly established hospital.

The Town Clerk read the letter he had addressed to the Chief Secretary and the Central Board of Health, by direction of the Health Committee on behalf of the council, with reference to the appearance of an epidemic disease. The latter expressed an opinion that the houses used as a hospital in Bourke-street west were unsuited to the purpose, being connected with adjoining buildings, and that the hospital should be in an insulated place: also, that the 34th section of the Act No. 31 had been disregarded, no notice having been given of the intention to open the buildings in question as a hospital.

Councillor M'Pherson stated that the Health Committee had reason to believe that these buildings would never be used as a hospital again.

The Mayor remarked that when the deputation waited upon the Chief Secretary, Mr. M'Culloch seemed to be fully impressed with the undesirability of a hospital for such diseases being placed in a thickly populated neighbourhood.

The report was adopted.37

The government's commission of doctors assigned to determine the nature of the illness duly reported on their view of the appropriateness of the Immigration Depot Hospital's continued use, and their report (under a categorically unambiguous headline of the newspaper's devising) can have done little or nothing to mollify an increasingly concerned citizenry:

THE SMALL-POX.

MEETING OF THE MEDICAL COMMISSION.

The medical gentlemen who were, on Saturday last, appointed a commission of inquiry by the Chief Secretary, yesterday inspected the Immigration Hospital, with a view to ascertain its fitness or unfitness as a place for the treatment of the cases now lodged there. After going over the whole premises, an expression of opinion was taken, with the following result, as embodied in a report by Dr. McCrea, chief medical officer, to the Chief Secretary:

"In compliance with the instructions contained in your memorandum of yesterday's date, ... I have the honour to report that --

  1. Dr. Thomas thinks the hospital is suitable for their treatment, and that it is not desirable to remove them.
  2. Dr. Motherwell thinks the hospital is suitable for their treatment, and that it is not desirable to remove them -- it could not be done with safety.
  3. Mr. James thinks the hospital is suitable for their treatment, and that it is not necessary, either for the safety of the public or themselves, that they should be removed.
  4. Mr. Pugh thinks the hospital is suitable for their treatment, and that it is not necessary, either for the safety of the public or themselves, that they should be removed.
  5. Dr. Barker thinks the hospital is suitable for their treatment, and that it is not necessary, either for the safety of the public or themselves, that they should be removed.
  6. Mr. Stewart thinks the Immigration Hospital unsuitable for the treatment of the present cases, and that the patients should be removed, but that their removal might be hazardous to themselves.
  7. Mr. Crooke thinks the hospital is unsuitable for the treatment of the patients, and that it is desirable to remove them.
  8. My own opinion is that the Immigration Hospital is a suitable place for the treatment of these cases, and that it is wholly unnecessary for the safety of the public, and undesirable for the patients themselves, that they should be removed."

(Signed) W.McCREA,
Chief medical officer.

It will be perceived that this inquiry in no way touches upon the nature of the disease from which the patients are suffering. That is a question not likely to be revived, unless some large outbreak of small-pox provokes further discussion -- an event which it is hoped will never occur. The object of this meeting and inspection was to reassure the inhabitants of the neighbourhood as to their immunity from danger; and if a preponderance of medical testimony will do that, the purpose must be admitted to be completely fulfilled.38

What little remaining confidence the public still had in the medical profession was finally beginning to crumble, as illustrated by the following contemporary report from an inner suburban newspaper, reflecting widespread concern that if the experts could not agree on a diagnosis for what were (rightly or wrongly) felt to be unmistakable symptoms, how could they be relied upon to provide appropriate treatment?

SMALL-POX OR CHICKEN-POX?

The public mind has been considerably agitated, for the past fortnight with a fear that we were in imminent danger of a visit from that fearful scourge small-pox. Hitherto we have been free from this terrible malady. A solitary case has now and again been imported into the colony, but the steps that have been taken have been sufficient to prevent its becoming acclimatised amongst us. But the fact that the original victim on the present occasion was taken to the Melbourne Hospital, where he not only died, but infected a patient who was in the same ward, who subsequently died, though from another disease, led people to think that less precaution had been taken than usual, and the danger of the disease spreading thereby so much increased. And these fears were not allayed when, on the second patient above referred to being removed from the Melbourne Hospital to the hospital of the Immigration depôt, several cases of what were thought to be small-pox broke out in that neighbourhood.

But we now come to the most remarkable fact in connexion with this subject. The patients in the Immigration Hospital have been visited by a number of medical men, and these are divided in opinion as to whether the disease is small-pox or chicken-pox. To an unprofessional mind this certainly seems strange, for one would think that small-pox, not a new disease, and presenting such marked outward appearances, would he readily pronounced on by the skilled eye. ... for those who claim to have had large practice and extensive experience of this particular scourge in the old country not to be able to agree as to whether what is now in the hospital at King-street is the comparatively harmless disease known as chicken-pox, or the highly dangerous one known as small-pox, we cannot help thinking is passing strange. Every one knows that medicine is not one of the exact sciences, and many believe that it is not so exact as it might and could be, but we think few will be found to dispute the fact that no two doctors who profess to know anything about the matter ought to differ as to what is small-pox. If they are thus at sea as to the disease itself, where will they be when they are called on to treat it -- if, unfortunately it should take root in our midst? The chances are we shall have as many different treatments as there are doctors. With internal diseases, where they have necessarily to grope much in the dark, we can understand and allow for great latitude of opinion; but of a disease possessing such marked outward symptoms we do not think it unreasonable to believe there should be something like unanimity in the profession in deciding when it is present.

Whether, however, the disease now located at the west-end of Melbourne be ultimately classed as chicken or small pox, it is the bounden duty of the Government and civic authorities, until the dispute is settled, to treat it as though it were the more dangerous disease. There can be no harm done by this, and there may be much good. We are glad to see that they are both acting promptly and energetically in the matter, and it is to be hoped the preventive means being adopted will have a most successful result. Had they been put forth a little earlier it would have been as well; but better late than never.39

The editorial column of David Syme's “Age” on Monday, January 18th, earnestly counselled against being lulled into a false sense of security, thinking that the worst was over, and even challenged the notion that the worst might only have been chicken-pox:

People who believe that the disease under which the patients in the Immigrants' Hospital have been suffering is smallpox are congratulating each other on its cessation without any new cases making their appearance. The few who believe that the disease is merely chicken-pox are exultant at the triumph of Dr McCrea over nine-tenths of the medical profession in the colony. Others, again, who have no decided opinion as to the character of the disease, are glad to find that nothing has occurred beyond what we then stated to justify the alarm which, nine or ten days ago, we considered it our duty to sound. To all these we say, Do not be in a hurry with your congratulations. The same sense of duty which led us to make the first alarm impels us to give warning that the danger is not past -- a warning rendered the more requisite in the face of the expressed intention of the medical authorities to discharge the convalescent patients. There is at the present moment more necessity for caution than at any former period.

The fact that no new cases have been of late reported proves nothing. The cessation of new cases is, indeed, one of the many indications that the disease is smallpox. The infection does not give the slightest indication of its existence until twelve days have elapsed from the reception of the virus into the system. The twelve days constitute the period of "incubation". Dr Marson, one of the best authorities, says: "Smallpox appears on the skin on the fourteenth day after the infection of the disease has been received into the constitution, the precise time being after thirteen times twenty-four hours have elapsed from the moment of taking the disease. Three or four instances have occurred in which it seemed likely the disease had appeared between the tenth and eleventh days after receiving the infection; they were cases occurring after vaccination, under which other stages of the disease are often interrupted, or cut short. Still these cases ... have been so few, they can hardly be relied on; but the others, on the contrary, so many in the aggregate, can hardly have failed to indicate the true time. The ordinary course is this -- after twelve days' freedom from illness there is severe indisposition for forty-eight hours, and then the eruption of smallpox begins to appear." From this it may be inferred, without risk of error, that, on the first appearance of smallpox in any country, the cases will occur in batches, with an interval between each, at first distinct, but afterwards becoming merged in each other. Thus, after the death of the man Bissell, admitted by the Chief Medical Officer himself to have been an undoubted case of smallpox, on the 15th of December, an interval of about a fortnight elapsed before the batch of cases now declared convalescent made their appearance. We now know the exact amount of mischief caused by the infection derived from Bissell's case; but it is too soon to look for the appearance of the disease on those who may have been in contact with the present batch of patients. Of course we cannot say that there will ever be another case, but we do say that the appearance of others should be anxiously looked for. There may not be a single individual in whom the disease is incubating, and there may be dozens, for there was a very reprehensible laxity in the enforcement of the rules, if there were any, as to the admission of visitors and strangers to the interior of the Hospital and to contact with the sufferers.

The precise nature of the knowledge we have of the course of smallpox renders it necessary in any inquiry as to its existence in any particular locality to pay particular attention to the history of each case. Dr Helm, who at the request of Dr McCrea, drew up a report of the cases, passes over their history in silence, although he of all others was in the best position for making inquiries. It was surely his duty to require the historical particulars before making his report. From Dr McCrea's rambling account of cases of chicken-pox at Sandridge and elsewhere, it may be imagined that if he could have given a history of the cases which would disconnect them from the deceased smallpox patient Bissell, or from the hospital in which he died, he would have done so. Dr Crooke is the only medical man who has paid any attention to the history of the cases, and he connects them in a sufficiently direct way with the immediately preceding case of smallpox. Is it not strange that Dr McGaurin, who must know more of the cases than any other man, has not been called upon to report upon them? Of the four patients, two stand in the relation of brother and sister, and the whole four are from a very circumscribed area in the neighbourhood of the Hospital. If the medical officers are ignorant of the history of the cases, the inhabitants of Shamrock-alley are not, for during the first week of the present month they gave unmistakable indications of preparing for a stampede. That they had reason for their fears is evident from the fact that the medical officers, paying homage to the superior skill in diagnosis displayed by the uneducated, vaccinated the whole of the residents in the neighbourhood. This was on the 6th of January. If this precaution was taken in time, the course of the infection may have been stayed. If, on the other hand, the disease was communicated to any of the neighbours prior to the 6th, we may expect to hear of some more cases in the course of the next three or four days. If that period passes over without fresh outbreak, the hope that the disease has been stamped out will be strengthened; but as we are credibly informed that until after the appearance of our "alarm" article there were practically no restrictions on visitors to the Hospital, it would be very unwise to rest in security. The disease may break out at any time within fourteen days from the complete recovery of the present patients, or at any indefinite interval, if proper care has not been taken to destroy every article of clothing or bedding with which they have been in contact.

Besides the medical men who declare that the disease is not smallpox, there are a few imperfectly educated members of the profession who endeavour to steer a middle course in the essential unity of smallpox and chicken-pox, in the difference between them being only in degree and intensity, not in kind. A few doubtful authorities are adduced in favour of the idea, but they are completely over-borne by a mass of authority of the highest order. The two diseases are not interchangeable; they are not mutually prophylactic; vaccination [ie, against smallpox] does not prevent chicken-pox; even modified smallpox (the disease as it appears in persons who have been vaccinated) never gives rise to chicken-pox. There is not, we believe, a single instance on record in contravention of these positions. To recapitulate authorities would occupy too much space, and we shall be very glad to find, from the cessation of the disease, that there is no occasion to pursue the subject. Whatever may be the result, our warnings are already justified, and if still attended to, cannot but lead to the conservation of the public health.40


Dr McGaurin had been in charge of the Immigration Depot Hospital at the time of the unfortunate Webster's admission, and as part of that process, had in fact been responsible for vaccinating (among other patients and staff there) Dr McCrea himself. Dr Crooke, who was himself also a member of the government-appointed commission of inquiry, had a week earlier filed his own emphatically dissenting opinion in the following letter to the press, shown here as it was originally published, immediately below another doctor's earnest attempts to distance himself from those who were still apparently uncertain about the true nature of what it was that they were witnessing:

SMALL-POX OR CHICKEN-POX ?

TO THE EDITOR OF THE ARGUS.

Sir,-- Will you allow me to correct an error in Dr. McCrea's letter, appearing in to-day's issue of The Argus? He states- "The next case that occurred was brought under my notice by Mr. Ford as a case of small-pox on the 16th December, in Stephen-street north; I visited the child, and saw it was varicella." I did not state it was a case of small-pox. The circumstances of the case were as follow:- A girl was vaccinated by me, and on the eighth day following the parents sent to say the child had small-pox. I immediately visited her, and found she was covered with an undefined but very suspicious-looking eruption, and at the same time she had four well defined vaccine vesicles on the arm.

I immediately sent word to the chief medical officer [regarding] the particulars of the case, and stated that I thought he should see the girl. He did so, and sent me word that it was a case of chicken-pox; but it turned out to be neither small- nor chicken-pox, but only an ephemeral vaccine eruption, lasting only two or three days. I trust you will give this letter space, as I do not wish it to be thought that I am incapable of distinguishing a case of small-pox from chicken-pox. In England for five years I had medical charge of some extensive parishes and mills, and saw a great deal of small-pox, and when small-pox was last here I saw a case, and detected the true nature of the disease immediately, before the distinctive characteristics of the disease -- viz., smell and pitting -- had manifested themselves.

I am, Sir, your obedient servant,

F. T. WEST FORD.

182 Collins-street east, Jan. 11.


TO THE EDITOR OF THE ARGUS.

Sir,- I am glad Dr. McCrea refers to Sir Thomas Watson as an authority in the present issue. I have great confidence in the opinions of this eminent writer, more especially as the description given by him of the symptoms of chicken-pox and small-pox exactly coincides with my experience. This fact will, I trust, shorten the controversy. Sir Thomas Watson states: "The disease is almost peculiar to infants and children of tender years; the eruption is preceded by little or no premonitory fever, commencing usually on the shoulders, neck, and breast; affecting almost always the scalp, but sparing very much the face, which in small-pox never escapes. The eruption is composed from the very first of perfectly transparent vesicles, surrounded by a very slight degree of superficial redness; they are usually numerous, but distinct."

Contrast this description with the symptoms in the cases at the Immigration Depot Hospital when I visited them on Thursday afternoon, the 7th inst.:

1, John Levy, aged eighteen years. Face very much swollen, natural expression totally destroyed, eyes nearly closed, surface of face studded with pustules nearly as large as peas, containing an opaque fluid, and showing depression with black point; they were also abundant on the chest, and in earlier stages of development on the trunk and lower extremities. Pulse small and rapid, tongue heavily furred, throat highly inflamed and tonsils swollen, effluvia from body and breath very offensive. This man had resided in the lane adjoining the hospital, where two men had recently died of unmistakable small-pox. He was attacked on the 27th of December with severe rigors, pains in back, loins, and limbs, followed by sore throat and pain in pit of stomach. I saw him on the twelfth day of his illness, and the eruption was then only at its height.

2, A woman, aged fifty years, a resident of the same lane, was lying on the occasion of my first visit in a most critical state, owing to want of sufficient vitality to throw out the eruption and pustules; there was a bright red patchy eruption on the face, great prostration, very difficult to rouse, throat livid and very much inflamed, and sloughs forming in the tonsils. Her condition had improved when I saw her on the 10th, the eruption having partially appeared, and showing some true small-pox pustules irregularly distributed over the face and arms. In the two other cases now advancing to recovery, I ascertained that the disease had been ushered in with rigors, pains in the back and loins, and sore throat. Is it possible to confound the symptoms I have thus hurriedly described with those of chicken-pox as given by Sir Thomas Watson, who says of small-pox (page l61), "both kinds (the confluent and discrete) are accompanied by sore throat, the tonsils and fauces [ie, the passage from the back of the mouth to the pharynx] tumid and red." It will be observed that this distinctive symptom occurred in every case, and this fact, coupled with the special development of the disease on the face, the peculiar severity of the symptoms, and the long duration of the attack, confirmed my opinion of the character of the disease, and induced me to press on the Government the necessity of immediate action in the matter.

I am, Sir, your obedient servant,

W. CROOKE.41


Within a week, however, while stepping back from appearing to have taken sides, the editor of the “Argus” was again cautiously venturing the opinion that the danger – whatever it was -- appeared to have been contained:

There is now every reason to believe that the disease -- whether small-pox or chicken pox -- which threatened so serious an outbreak in the neighbourhood of the Immigration Hospital, has been permanently put out. Since the adoption of precautionary measures, as well by the health officer of the city as by the chief medical officer, not a single case has been reported, while those already in hospital have gone on favourably from the beginning, and may now be regarded as cured. At Heidelberg, however, a similar disease seems to have made its appearance. On Sunday Dr. McCrea received information from Dr. Bleeck, of that place, that, at the village of Greensborough, there were more cases of what he believed to be chicken-pox, but they were of such a nature that he desired the opinion of another medical man upon the subject. In compliance with this request Dr. McCrea despatched Dr. Helm to the assistance of Dr. Bleeck, but his report has not yet been received.42

At Greensborough, where the disease had quietly taken root more than a month earlier, there were now some twelve patients to be examined, and Dr Helm finally lodged an opinion that he would soon come to regret, namely, that as far as he could tell, all were suffering from chicken pox:

THE SMALL-POX OR CHICKEN-POX AT GREENSBOROUGH.

The following is Dr. Helm's report to the chief medical officer on the cases of supposed small-pox at Greensborough :--

"In forming an opinion upon the exact nature of these cases of sickness, the first point which it is desirable to settle is whether they differ so much from one another as to justify their being classified as distinct diseases; or whether they are only examples of one and the same disease expressing itself in various degrees of intensity in different subjects.

The disease has hitherto invaded three houses. In the first house, that occupied by the Limmers, seven cases have occurred in thirty-five days. In no case has the disease manifested itself in any degree of severity, yet some have ... suffered more than others; i.e., the disease, whatever it is, has varied in intensity in the same house.

It was in this house that the disease first appeared on December 10, 1868 ... This patient is the only one of those affected who has lately been to Melbourne, and he must, I think, fairly be regarded as the source of the infection of the neighbourhood. His visits to Melbourne have been made for some time regularly every other day; he carts wood into Brunswick-street, but he has also, with his team, lately passed through other parts of the town. The occupants of this house are the husband, wife, seven children, and a son-in-law -- in all ten persons; of these, seven have had the disease ... four are distinctly similar in one very important particular, viz. the period elapsing between the first appearance of derangement of the general health (or the period of sickening, as it is usually called) and the date of the appearance of the eruption, which in each of these four cases was the same, viz. three days. The remaining three cases ... have been so slightly affected that ... no date can be assigned as the period of sickening. ...

The second house invaded by the disease is one [that is] eighty yards distant from the Limmers'. It is inhabited by husband, wife, and three children (five persona in all), of whom four had had an eruptive disease since December 20, 1868. In this house the disease must have varied most in intensity, for one patient ... presents the remains of a very copious eruption. ... In twenty-one days, therefore, there have been in this house four cases of an eruptive disease ... all present exactly similar symptoms, and are undoubtedly subjects of the same disease. ... these four cases of eruptive disease occurring in the same house within a period of twenty-one days, are specimens of varying degrees of severity of the same disease. That the disease is the same as that which has prevailed in Limmer's house is shown by the similarity of the symptoms, and by the interval between the sickening and the appearance of the eruption being of the same length in all the cases ...

In the third house, inhabited by husband, wife, and new-born child, the wife only has been attacked. She ... visited case No. 1 on December l8, five days after the appearance of the eruption on him.

I have now clearly proved that ... all those twelve cases are cases of varicella, or chicken pox. Indeed I know of no other disease to which they can he referred.

Eleven of these patients have been vaccinated efficiently at various times; the remaining case ... has never been vaccinated; she would, therefore, be of great service, supposing I had any doubt as to the nature of the malady, in proving that the disease, whatever it is, is one which cannot be in any way the result of the modifying effects of vaccination. But she is of still greater service by reason of the confirmation which she gives to my opinion that these cases are in no way connected with small-pox, either in its modified or unmodified forms; for, had she been exposed to the contagion of small-pox, she was the one person amongst the whole number in whom the disease, if it partook in the least of the nature of small-pox, would, from her not having been vaccinated, have found a most fitting receptacle, and it would, consequently, be expected to produce in her the worst results possible, instead of which she is the subject of mild unmistakeable varicella, or chicken-pox.

Two other points in connexion with those cases I will direct your attention to, without commenting upon them, as they are sufficient of themselves to refute any idea as to the possible connexion of these cases of disease with small-pox:--

  1. The very short time in which the disease in all cases ran its course ...
  2. The total absence of any of the secondary disorders which are so frequently met with in cases of variola, or small-pox. It may be satisfactory to you to know that my subsequent experience at Greensborough has strongly confirmed me in the opinion that the cases which I saw in the Immigration Hospital some time ago, and reported on to you, were cases of varicella, or chicken-pox, and nothing else.

I hope I shall not be presuming if I express entire concurrence in all the measures which Dr. Bleeck has adopted to prevent the spreading of this disease at Greensborough. I can suggest no improvement on them.

I am, Sir, your obedient servant,

George F. Helm,
M.A. (Cantab), M.D., F.R.C.S.
43


Dr McCrea had firmly hung his hat on the endorsement provided by Dr Helm's opinion. But in the space of less than a fortnight, the value of visiting celebrities was thrown into question when the whole issue was re-ignited, and the riddle of the nature of the disease was finally resolved to Dr McCrea's satisfaction for once and for all, if in a rather unfortunate way:

The long-agitated question, "small-pox or chicken-pox," has been at last definitely answered in a manner little expected. Two of the patients at Greensborough are dead -- the infant of Mrs. Whatmough, and a man named Rose -- and the symptoms which were developed in the progress of the disease in these two cases have induced Dr. McCrea to change his opinion as to its nature. The chief medical officer was over at Greensborough yesterday; he carefully inspected all the cases, and came back satisfied that not only the two dead persons, but also a third (Mrs. Chapman), who has taken the infection from nursing Mrs. Whatmough, suffered from veritable, genuine, small-pox. Further than that, his investigations have carried him to the conclusion that so far as Greensborough is concerned the epidemic there has been all along a modified form of small-pox. As it is admitted that the disease was communicated to the sufferers at Greensborough through a too close intercourse with the infected neighbourhood in Melbourne, it follows as a consequence that the same conclusions must apply to the outbreak here. This result fully confirms the truth of our observations in reference to this subject in The Argus of January 9, where we plainly stated :-- "The truth is that the disease, as it has appeared in this city, is modified small-pox, but though modified, still absolutely and certainly small-pox; and investigations of late years have led to the conclusion that many cases of what is frequently regarded as varicella are true variola, and between these, as may be readily imagined, there is little if any difference." And, again, two days after, when Dr. McCrea had taken objection to our statement: "These cases are not those of absolute and typical variola, and they are in like manner removed from what may be termed representative varicella; but as their leading indications point to the former disease, it is only reasonable to conclude that they are akin to it." The reasonableness of the conclusion is no longer disputed, and it is satisfactory to have been able, even at so sad a cost, to determine a dispute which had begun to assume a disagreeable and almost personal aspect.

At the same time no charge of indifference or apathy can be properly brought against the chief medical officer. Though he was under the impression that the disease was not small-pox, the same precautionary and preventive measures have been taken as if that scourge was threatened. Vaccination, disinfectants, isolation of patients, and the destruction of infected articles -- these were the means employed from the first, and so well has the work been done that the disease seems extinguished in the city. Greensborough remained too long without attention, simply because attention was not called to it, but now tents, bedding, stores, and every necessary to complete isolation are on the spot, and nurses are advertised for to attend upon the sufferers. We regret to learn that three or four fresh cases are reported as having occurred at Diamond Creek, a place three or four miles from Greensborough. It was also rumoured that a person had been taken ill at Prahran, but the report is as yet without confirmation.

It will be seen by our advertisement columns that, in consequence of the prevailing panic, the public vaccinator for Melbourne has thought it advisable to increase the number of mornings for vaccination from one to three, until further notice.44


The death of the unvaccinated "new-born child" from the Whatmough household must certainly have dampened the discredited Dr Helm's enthusiasm for using 10-month-old Caroline Mills, also unvaccinated, as any sort of poster child for how harmless he thought the disease actually was.

Melbourne Hospital in 1867

Another view of Melbourne Hospital, in 1867
Courtesy RMH Archives

Intermittent hospitalizations continued to occur, but on a lesser (and diminishing) scale. By late February, Melbourne's medical fraternity could relax enough to be able to snipe at one another in what looks like some form of turf war, as shown by this report of a meeting of the Victorian Medical Association which discussed the apparently excessive numbers of coronial inquests, as well as reaffirming the need for public vaccination against small-pox:

An adjourned meeting of the Victorian Medical Association was held yesterday evening, at the Port Phillip Club Hotel. There were present -- Mr. Stewart (the president) in the chair, Mr. Moore, Dr. Borncastle, Dr. Reeves, and Dr. McCarthy ...

Some discussion ... took place on the subject of inquests, and a general opinion was expressed to the effect that the present system stood much in need of alteration. Inquests were stated to be too frequent. As many took place in Melbourne as in London, and most of them were quite uncalled for. Post-mortem examinations, too, were spoken of as being insisted on in cases where they were not at all needed, and it was alleged that when a man died suddenly, no matter how natural the cause of death, an inquest was held, and very likely a post-mortem examination. The course suggested by the meeting was a police investigation in the first instance touching the circumstances of any death, and then, if a taint of suspicion were found, an inquest and post-mortem might be held.

Having discussed this lively subject with much apparent enjoyment for about an hour, the medical associates next proceeded to exchange ideas upon the small-pox question. Dr. McCarthy re-read the interesting paper with which he had favoured the company on the occasion of their preceding meeting, and in which he pointed out the distinctions between the chicken-pox, small-pox, cow-pox, and modified small-pox, and how far the affinities of each had extended. Mr. Moore also re-read his essay upon the same absorbing subject, and made it appear that everybody should be vaccinated without delay. These contributions to medical literature having been thus introduced to notice, the members of the association criticised at great length, not only the papers in question, but other papers which had been laid before other societies. They were particularly severe upon the Medical Society, and expended a considerable amount of virtuous indignation, not unmingled with pity, upon the admirers and supporters of that body. Having talked themselves into a very cheerful condition, the jovial quintette tore themselves away from each other sometime between eleven o'clock and midnight.45

By March 1st, the newspaper's monthly digest of news from the new colony, the “Summary for Europe”, was reporting sanguinely that whatever it was, we seemed to have gotten away with it:

SUMMARY FOR EUROPE.

The question whether a certain disease which had made its appearance in Melbourne and other places was small-pox or chicken pox was at the date of our former summary dividing the doctors of Melbourne. At length the chief medical officer, who had for some time taken the latter view, became convinced that in some cases the disease was small-pox. Two of the patients died, but to the present day many of our leading medical men deny that in any case, save that of a man who was brought ashore from the ship Avon Vale, was the disease genuine small-pox. But at any rate it is satisfactory to be able to state that whatever it was it has not extended, and has yielded to the method adopted for its extinction. In the meantime the colony has had to suffer the temporary inconvenience of being treated as suspected by the adjoining colonies, who have enforced quarantine regulations upon vessels arriving in their ports from Melbourne.46

But as had unfortunately become the pattern of this outbreak, on the local news pages of the very same edition, the following article might have given the writers of the above some pause:

A case was admitted at the Melbourne Hospital on Saturday night last, which, on examination yesterday morning, Mr. Ashworth, resident physician, pronounced to be one of small-pox. The patient's name was Peter Adger, a Scotch labourer, who has been recently employed in the neighbourhood of Hawthorn. Mr. Ashworth immediately sent for Dr. McCrea, who agreed as to the diagnosis, and had the man conveyed at once to the depot in the Royal-park. All the necessary precautions, such as vaccinating patients in the same ward, the use of disinfectants, &c, were taken at the hospital to prevent the spread of the disease.47

Within days, Greensborough had again become the focus for further fresh reports of suspected smallpox cases:

Greensborough is again threatened with an outbreak of small-pox. A fresh case was yesterday afternoon officially reported to Dr. McCrea as having occurred there, and he at once went out to examine the patient. We have not yet learned the result of his visit.48

By the middle of March, the extraordinary co-incidence of the disease simultaneously striking a brother and sister who lived in different areas and had had no known contact with one another re-ignited the enthusiasm of the “Argus” for even more stringent measures to be taken:

Two other cases of small-pox occurred in the city yesterday, which present the same peculiar feature of isolated seizure as has been remarked upon in several other instances. The sufferers in the present case are brother and sister, but they live in widely different localities, and have not been known to have any communication with each other for a long time. They were attacked simultaneously -- one in Latrobe-street, and the other in Queensberry-street, North Melbourne -- and have been, we are informed, removed to the depot at the Royal Park.

The occurrence yesterday of two fresh cases of small-pox in Melbourne but too surely proves that as yet the disease is not stamped out. Indeed, instead of this being the case, there is sufficient reason to induce the apprehension that, unless very prompt and energetic action is taken, the spread of the epidemic may become rapid. It is a singular fact that the two persons who were yesterday attacked are brother and sister; but they have had no communication with each other for a considerable period, the one residing in Queensberry-street, North Melbourne, and the other in Latrobe street. If it be true, as is alleged by the relatives of the patients, that they have not even seen each other for some time, then the coincidence, extraordinary as it undoubtedly is, points to the fact that already the germs of the disease are widely distributed, and that the necessity for the adoption of stringent precautionary measures is greatly intensified.

The history of this disease is pregnant with valuable information. It has been carefully observed, the statistics relative to it have been assiduously collated by some of the most eminent medical men of the United Kingdom, and from the information thus obtained it is not difficult to ascertain the best means of dealing with and suppressing an epidemic so repulsive and fatal. It is one of the peculiarities of small-pox that it at first extends but gradually and by slow degrees. It does not, like cholera, suddenly break out, and at once lay prostrate a large proportion of the population of the locality in which it appears. Perhaps for two or three months only an occasional death occurs; but if proper precautions are not taken to check its insidious progress, its virulence becomes more marked, the number of cases rapidly increases, and the disease assumes a most alarming aspect. Thus, in 1857, when the epidemic broke out in Sheffield, there were in the month of May only three cases, in June three, in July ten, in August fourteen, and in September sixteen. Up to this time the disease had made but small strides. No adequate precautionary measures, however, appear to have been taken, and the consequence was that in October, November, and December the deaths amounted to no less than 132. Such facts as these should teach us a valuable lesson. It is now a question of secondary importance how the small-pox arrived here. Here it is, it has become widely disseminated, and the one thing that demands immediate attention is, how are we to get rid of it? ...

The epidemic has not as yet assumed alarming proportions here, and, if the proper steps be promptly taken, the disease may still be fairly stamped out.

There is, however, no time for delay; every moment is of value; the occurrence of two cases, separated from each other by at least a mile, proves that the seeds of the disease lie lurking amongst us, only awaiting a favourable opportunity to develop themselves. The two cases to which reference has been made, have, we are informed, been already removed to the Royal Park. So far the isolation is complete; but this is not sufficient. The residents in the immediate localities should be revaccinated, disinfectants should be used with no sparing hand, and a vigilant watch should be maintained, so that at the slightest indication of the disease in another patient, all communication with the diseased person may be prevented, and the spread of the disease be thus rendered almost an impossibility.49

By this time, roughly the middle of March, 1869, the disease was not only striking apparently at random throughout the suburbs, but was also regrettably afflicting a better class of victim, too:

One of the saddest instances of the uncertainty of human life that has for some time come under our notice is the untimely death of Mr. James Glover (of the firm of Messrs. M'Culloch, Campbell, and Co., Bourke street), which took place yesterday morning, at his residence, Domain-road, South Yarra, of small-pox. Mr. Glover, only a few days ago, was actively engaged in the furtherance of the affairs of the new omnibus company, in which he held a considerable stake, and took a large amount of interest. He attended the Fancy Dress Ball, where he wore a suit of armour, which he afterwards exchanged for a lighter suit. Next day he felt somewhat unwell, and in the course of the past week he felt indisposed for business, and did not come into town. His illness rapidly developed itself, and on a medical man being called in, it was ascertained that the case was one of small-pox, and of so severe a character as to leave but little hope from the first. Consciousness speedily passed away and only returned a few hours before death, which, as we have said, occurred yesterday morning. The interment of the body took place in the cemetery in the course of the afternoon, every precaution having been taken that could be thought of. Mr. Glover was only twenty-nine years of age, strong and healthy up to the moment of seizure. How he became attacked can only be conjectured; for he had not been in any neighbourhood where the disease has shown itself. He had but lately returned from a visit to Scotland, his native country, and having been fortunate in business, had a fair prospect in life before him. He was warm-hearted and generous, and has left many friends to regret his loss. No fresh case of small-pox, we are glad to say, was reported yesterday to the chief medical officer.50


Citing an article that was published in the Australian Medical Journal of May, 1882, referring to the 29-year-old Mr Glover, the Health Department's 1914 “History of Smallpox in Australia, 1788-1908” (shown below) said that “It long remained a mystery how this gentleman came in contact with the disease, but at last a satisfactory explanation was obtained.” Possibly to avoid speaking ill of the dead, however, unfortunately, “There is no statement as to the nature of the explanation.”51

1914 Health Department Report on Smallpox in Australia

1914 Health Department Report
Courtesy Internet Archives

For as regrettable as they surely were, these were nevertheless to be among the last of the manifestations of this deadly scourge, which, in the aggregate, had afflicted a total of 42 people and taken the lives of nine of them, between late November, 1868 and early May, 1869 ...

      ... in the greater metropolitan area ...


Footnotes

01 N Barquet and P Domingo, “Smallpox: the triumph over the most terrible of the ministers of death.”, published in the Annals of Internal Medicine, October 15, 1997, cited in Edward Jenner and the history of smallpox and vaccination, retrieved 25th April, 2013.
02 The “Argus”, Saturday, November 28th, 1868, p 4
03 Commonwealth of Australia Quarantine Service, “The History of Small-Pox in Australia 1788-1908”, publ. 1914, at the Internet Archive, retrieved 2nd October, 2012. While comprehensive, its entire treatment of what it calls Victoria's "Second Epidemic" of 1868-9 is based exclusively on Dr McCrea's report to the Victorian Central Board of Health of 1871 and "other official reports by Dr. McCrea", including, for example, his stated belief that the disease was probably spread by flies. The first epidemic had been in 1857, when 16 were infected and four died, again as a result of a contagious seaman, from on board the "Commodore Perry".
04 The “Argus”, Saturday, November 28th, 1868, pp 4-5. The Avonvale was towed to the “Quarantine ground” at Point Nepean on the same day.
05 The “Argus”, Thursday, 3rd December, 1868, p 5.
06 From “The Portland Guardian and Normanby General Advertiser”, Thursday, 3rd December, 1868, p 3
07 The “Argus”, Tuesday, 15th December, 1868, p 4
08 Hobart “Mercury”, Monday 21st December, 1868, p 2 (from the Melbourne "Age")
09 The “Argus”, Wednesday, 9th December, 1868, p 5
10 From an ancestry.com thread on “MARINERS”, retrieved April 14th, 2013.
11 The “Argus”, Monday, 7th December, 1868, p 5.
12 The “Argus”, Tuesday, 15th December, 1868, p 5
13 The “Argus”, Wednesday, 16th December, 1868, p 5
14 The “Argus”, Saturday, 19th December, 1868, p 5
15 The “Argus”, Tuesday, 22nd December, 1868, p 5
16 The “Argus”, Wednesday 23rd December, 1868, p 4
17 The “Argus”, Wednesday 23rd December, 1868, p 5
18 The “Illustrated Australian News for Home Readers”, Friday, 20th December, 1867, p 12
19 Dept of Planning and Community Development : Maritime Infrastructure Heritage Project -- “Jetties and Piers”, retrieved March 2nd, 2013.
20 From Peter Shaw's “Shawfactor” blog: “Melbourne city”, retrieved 14th May, 2012.
21 From “The Illustrated Australian News for Home Readers”, Tuesday, August 27th, 1867, p 6; engraving is from the “Illustrated Sydney News”, Thursday 23 December 1869, p 9
22 The “Argus”, Thursday, December 24th, 1868, p 5
23 “Pennyweight Kids” by A R McMillan, publ. Castlemaine, 1988 pp 76-77, literatim in places from the following “Australian Dictionary of Biography” citation.
24 University of Melbourne School of Historical Studies “eMelbourne -- The City Past and Present” website, retrieved 4th September, 2012.
25 “Australian Dictionary of Biography” entry for William McCrea (1814-1899) by David M O'Sullivan, retrieved 6th November, 2012.
26 From PROV Agency descriptions: Agency VA 475, Chief Secretary's Department, retrieved 10th January, 2012.
27 ibid.
28 The “Argus”, Monday, 28th December, 1868, p 4
29 The “Argus”, Tuesday, 5th January, 1869, p 5
30 The “Argus”, Thursday 7th January, 1869, p 5
31 The “Argus”, Monday 11th January, 1869, pp 5-6
32 The "Argus", Saturday, January 9th, 1869, p 4 -- As the "boomer bulge" works its way up the demographic pyramid, centenarians have become so unexceptional that newspapers attract greater reader attention from reports that the first person who will live to enjoy a healthy 150th birthday has already been born. It is therefore doubly salutary to reflect that almost that many years ago, the woman referred to in the article from the "Argus", who shares the distinction of being one of the two equally oldest victims who developed smallpox symptoms (the other of whom died from it), and who was described in the article as "elderly", was in fact only 50 years of age!
33 Kristin Otto, “Yarra” (Text Publishing, Melbourne, 2005), p 70
34 In fact, this was the 17-year-old girl already mentioned, who had visited her parents in proximity to the Immigration Hospital in early December.
35 The “Argus”, Monday, January 11th, 1869, p 5
36 The “Argus”, Monday, 11th January, 1869, pp 5-6
37 The “Argus”, Tuesday, January 12th, 1869, p 6. Shamrock alley was a lane off Bourke Street, between King and Spencer Streets.
38 The “Argus”, Wednesday, January 13th, 1869, p 6
39 “The Telegraph, St Kilda, Prahran and South Yarra Guardian”, Saturday, January 16th, 1869, p 2
40 “Age”, Monday, January 18th, 1869, p 1
41 “Age”, Tuesday, January 12th, 1869, p 5
42 The “Argus”, Tuesday, January 19th, 1869, p 5
43 The “Argus”, Thursday, 21st January, 1869, p 6
44 The “Argus”, Tuesday, February 2nd, 1869, p 6
45 The “Argus”, Saturday, February 20th, 1869, p 5
46 The “Argus”, Monday, March 1st, 1869, p 18
47 The “Argus”, Monday, March 1st, 1869, p 5
48 The “Argus”, Thursday, March 4th, 1869, p 4
49 The “Argus”, Saturday, March 13th, p 5
50 The “Argus”, Wednesday, March 17th, 1869, p 5
51 “The History of Small-pox in Australia, 1788-1908” (op. cit.), p 40.
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