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45
Report of the Medical Officer of Health.
In the report for the year 1909 a table was included showing the cancer deatn-rates in the
period 1901-9 in areas presenting different degrees of overcrowding, the object being to compare the
death-rates of populations differently circumstanced in respect of "social condition"

condition,"
1911.
These figures and those contained in previous reports appear to indicate that there is no
relation between cancer mortality and social condition, whether measured by the degree of overcrowding
or by the percentage of children scheduled for compulsory education, and in this respect
the behaviour of cancer differs altogether from that of phthisis (see page 42).
Cerebrospinal Fever.
During 1911, 101 persons were certified to be suffering from cerebro-spinal fever and 9 deaths
were attributed to this disease.

As stated in the last annual report, the larger number of deaths attributed to this cause in 1907
was probably an indirect effect of the Council making an Order requiring cases of this disease to be
notified. The requirement of notification did not become operative until the 12th of March, 1907,
and during the remainder of that year 135 cases were notified, or 50 more than in the whole of the year
1908. In 1909 there were 111 notified cases, and 115 in 1910. In March, 1911, the Council
extended the Order for another period of twelve months.

Three of the deaths were those of infants under one year of age, four of infants aged between
one and five years, and the remaining two those of persons over five years of age. No cases were notified
in Chelsea, Hampstead, Stoke Newington, Holborn, City of London and Deptford.
Inquiry was made into the notified cases by Dr. Wanklyn, who found no evidence that
any one verified case was connected with another. Of the 101 cases notified, in 57 the final diagnosis
confirmed the original diagnosis, in 18 this diagnosis was reversed, and in the remaining 26 the
evidence was doubtful. Of the 57 cases verified on final diagnosis a post-mortem examination was
made in 15 and bacteriological evidence was obtained in 25; the nature of this evidence was usually
not stated, and as the examinations were made by different bacteriologists, there would in all
probability be varying definitions of what might be considered as bacteriological evidence of the
disease.
Anthrax.
On the 6th April, 1909, the Council made an Order requiring the notification of cases of glanders,
anthrax, and hydrophobia in man ; the Order came into force on the 26th April of that year.
(«) See footnote (6), page 11.
(6) See footnote (b), page 7,
(c) See footnote (c), page 2.