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disinfects a blanket, and in the present imperfect state of our
knowledge of the sources of infection in Scarlet Fever the
absolute prevention of " return cases " appears hardly
practicable. For some time past the London Medical Officers
of Health have endeavoured to induce the Metropolitan
Asylums Board to furnish them with the dates on which it
was proposed to discharge from hospital recovered cases of
Scarlet Fever and Diphtheria, and early in 1903 the Board
arranged that this should be done. The first intimation of
discharge was received in Battersea on March 13th, and
since then it has been a duty of the Lady Sanitary Inspector
to visit the homes to which recovered patients are to return
and to advise the mothers to take certain precautions, for
instance, not to allow the child to sleep with other children
soon after his return. She also ascertains to what school it
is proposed to send the patient, and a letter is then addressed
to the Head Teacher requesting that the child be excluded
from school for a fortnight after his return home. This
procedure appears to have been beneficial. Of the 35 cases
which occurred during the year, 16 occurred before and 19
after March 13th, when the first intimation of discharge was
received, and in 8 of the latter cases the house was not visited
owing to pressure of other work.
Enteric Fever
The case-rate, death-rate and case-mortality from Enteric
Fever since 1891 are set out below:—