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London is estimated at the round figure of £500,000. This large sum, however, when
the huge size of the Metropolis is taken into account, appears on the whole to be a
moderate expenditure, and taking into consideration the results obtained—for I doubt
if there has ever been an outbreak of small-pox in London or elsewhere, dealt with
more effectively with respect to the isolation of the cases—it must be regarded as
money well laid out. The payment of the greater part will be spread over a term of
years, but if the whole cost were at once defrayed, it would mean about a 3d. rate for
the Metropolis. A 3d. rate in Shoreditch would yield a little over £9,000.
The cost of such epidemics as the one just past in suffering, through death, loss
of employment, and interference with business can never be known.
SCARLET FEVER (SCARLATINA).
The cases of scarlet fever certified during the year numbered 249, which is the
smallest number in any year since the notification of the disease became compulsory.
Intimations were received from the Metropolitan Asylums Board that in eight of
these cases the patients were not suffering from scarlet fever. In the report for last
year (1901) is given a table shewing the number of cases yearly certified from 1889 to
1901.

Of the cases certified nearly 94 per cent. were removed to hospital for treatment
as compared with 88 per cent. in 1901, 83 per cent. in 1900, 85 per cent. in 1899, 86
per cent. in 1898, 75 per cent. in 1897, 70 in 1896, 60 in 1895*, 65 in 1894, and 37 per
cent. in 1893*.
*During portions of these years, owing to lack of accommodation at the fever hospitals, many cases
had to be treated at home which would otherwise have been removed to hospital.