Previous to the cholera epidemic, small-pox was very prevalent in London, and I very carefully noted the cases as they were reported, and visited the districts where the disease was most prevalent, for the purpose of testing the nature of the gases in the sewers, and observing how the sewers and sanitary fittings were constructed.

In many of these districts, and especially those of Homerton, Hackney, Bow, and Bromley, the drains are so laid and the fittings so constructed that a supply of sewer gas is pumped into the houses, and it is impossible for persons to live in the houses of these districts without inhaling gases that have been for a long time in contact with sewage matter.

Bad Drains; and How to Test Them: — Part 33

Whether the small-pox poison is an organic one (which I believe it is), and is produced from a collection of matter in a high state of decomposition, with or without being mixed with the excreta of persons suffering from the disease, or whether it is of an inorganic nature, the poison is derived from this source rather than from the impurities thrown off through the skin of persons suffering from the disease. As a proof of this, as soon as the cholera broke out last year on the Continent, almost every gulley and grating in the metropolis where sewer gas passes was charged more or less with a disinfectant, which minimised the poison in the gas. The result was that small-pox abated in an epidemic form although the temperature of the atmosphere increased.

Bad Drains; and How to Test Them: — Part 33

The disinfectants so placed could not, naturally, affect the gas in branch drains to houses, or putrid matter in various parts of the sewers, or if it had, judging from its beneficial effects at the outlets, small-pox would have disappeared.

Bad Drains; and How to Test Them: — Part 33

If contagion were the means by which this disease was distributed, disinfectants at sewer gratings would not have prevented the disease continuing in an epidemic form.

Take the adjoining districts of Fulham and Putney. During the epidemic, the gases from the sewer gratings in the Fulham district were more dense than those at Putney. Fulham had many cases of small-pox, but Putney none, although persons from each district were in daily contact with each other; but the houses were not connected by the same system of sewers.