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22 [Appendix IV.
trifling character and call for no active interference on the part of the Department. In former
Reports attention has been called to the periodical recurrence of cases of erysipelas in the same
individual. No such case came under the notice of the Department during the past year.
As will be seen by the figures above, there was a reduction of the number of cases reported last
year compared with the decennial average, but the rates given in Table 10 (p. 11) show that the
rates for last year differed only to a very slight extent from the mean rates for the previous five
years. In North Paddington 104 cases were reported, compared with 125 in 1899 and a decennial
average of 125, while in South Paddington 16 cases occurred, or 1 less than in 1897 and 3 less
than the average.
The local rate (0.92) was very nearly midway between the highest rate prevailing in the
adjacent districts (1.43 in Marylebone) and the lowest (0.57 in St. Greorge, Hanover Square).

There has not been any material reduction in the prevalence of this disease, although, perhaps,
the number of cases recorded last year was slightly increased in consequence of a circular letter sent
out by direction of the Public Health Committee, to which letter more particular reference will be
made later. The cases reported last year were 1 fewer than the total for 1899 (7) and 2 less
than the decennial average. Fewer cases were recorded in 1890 and 1898 (5 cases in each year),
and in 1891 and 1894 (4 cases in each year).
All the cases reported last year occurred in North Paddington. No case has been reported
from South Paddington for the past six years. A reference to Table 10 will show that the sicknessrate
for this disease, calculated on the number of females estimated living, was last year equal to
the mean rate, and was 0.1 per 1,000 females in each case. Having regard to the reduction in the
numbers of births registered in recent years, it will be more instructive to inquire as to the ratio of
notified cases to births registered.* A comparison is instituted below:—

It is worthy of note that in 1893 and 1896 scarlet fever was exceptionally prevalent in
Paddington.
The inquiries made enable the cases recorded last year to be tabulated as below:—
Illness after neglected miscarriage 1 case.
Illness after confinements 5 cases.
Including, child born dead ; instrument case ; and child abnormal in formation, 1 each.
All the confinements were reported to have been conducted by medical men, while of the
nurses or midwives in attendance, 3 were trained women. In all 5 houses the sanitary
arrangements were defective, some being very bad. In 3 cases there was evidence of the escape
of drain (or sewer) effluvia into the rooms where the patients were confined, In 1 house, where
the case terminated fatally, 2 cases of scarlet fever (children of the deceased woman) had been treated
* As a certain number of reported cases occur in connection with miscarriages and abortions, this comparison
overstates the case, but it gives the best information available.