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During September, October, and November the disease
was almost entirely confined to the Lewisham portion of the
District, and a large number of the cases occurred in an
area of about a quarter of a mile, limited on the north to
the division between Lewisham and Greenwich; to the east
following the River Ravensbourne to its junction with the
Quaggy, and then following the Quaggy to the point where
that stream crosses High-street, Lewisham. The boundary
then follows the High-street to Roiner-place, and proceeds
westward, joining the Ravensbourne just below Riverdale
Mill. It then follows the course of the river to the South
Eastern Railway line, and from there southwards to Ladywell
Station; then passing round the slope of the Hilly
Fields to the point of junction of the Lewisham and Greenwich
Districts. In this area there had been 14 cases of
diphtheria notified between July 28 and August 23, and
fresh cases kept on occurring, and during the last week in
September, and the first three weeks in October the cases
kept gradually increasing in number. Every case was
moved at once, when possible, and the premises thoroughly
disinfected; a house to house inspection was ordered in
this area, which was thoroughly carried out by the two Inspectors
who were told off especially for this work. One of
the great difficulties with which we had to contend, was the
delay in moving cases, owing to the Asylums Board Hospitals