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37
to bacteriological examination and to the closure of the school for the Easter holidays. Dr. Priestley
mentions the occurrence in the children's ward of a hospital in Lambeth of two cases of diphtheria,
which were attributed to infection by the ward attendant who was found to be harbouring diphtheria
bacilli.
Of the cases occurring in Woolwich, the source of infection was noted by Dr. Davies to be in
56 cases other inmates in the house, in 30 cases schoolmates, in 14 neighbours and friends, in
6 return cases, and in 1 a general hospital. In Finsbury, where 130 actual cases occurred, Dr.
Porter traced 22 cases to infection at home, 7 to infection at school, and 9 to infection elsewhere,
in 3 instances the disease was possibly contracted from cats. Dr. Bryett states that in Shoreditch,
where 210 cases were notified, 82 were attending school, 67 within a week of being certified,
while some were actually suffering while at school and before their illness was recognised; 78 other
cases occurred in houses from which children were attending school, although the actual patients were
not school attendants, and in 28 cases there was antecedent sore throat in the house.
Dr. Davies gives particulars of the day of illness on which medical aid was first obtained in 64
cases where this fact was noted. The first visit of a medical man took place in little more than a
third of the cases on the first day, and in nearly one-third on a day subsequent to the second day.
The extent to which multiple cases in houses occurred is mentioned in the reports relating
to Paddington, Fulham and Holborn (in which districts there were respectively a total of 150, 400
and 50 cases notified). The figures given are as follows :—
Paddington. Fulham. Holborn.
Houses with 2 cases 8 28 1
„3„ 8 28 1
„4„
1 1 1
•••
In these 49 houses, therefore, there were 113 cases, or 64 after the primary case, the subsequent
cases being 10.7 per cent, of the 600 cases notified in these districts.
Proportion of cases of diphtheria removed to hospital.
It will be seen from diagram XIII. that the proportion of cases of diphtheria removed to the
hospitals of the Metropolitan Asylums Board was about the same as in the preceding year.
Whooping-cough.
The deaths from whooping-cough in the Administrative County of London during the year 1890
(53 weeks) numbered 984, as compared with 1,786 in 1907 (52 weeks).

The death-rate in each year since 1840 in relation to the mean of the period 1841-1908 is shown
in diagram XV., while the deaths in each month since 1890 in relation to the mean monthly deaths
of the period 1891-1908 are shown in diagram VIII., page 25.
1See footnote (1), page 8.
2 Including deaths of Londoners in the Metropolitan Workhouses, Hospitals, and Lunatic Asylums outside
the County, but excluding those of non-Londoners in the London Fever Hospital, the West Ham Union Workhouse
at Hackney, the Metropolitan Asylums Hospitals and the Middlesex County Asylum, within the County of London.
21322 F