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before the nature of their disorder was recognised. In 48 other instances, although
the patients were not attending school, other children resident in the same houses
as the patients were. In 13 instances there had been cases of "sore throat" amongst
the inmates of the patients' houses, and in 12 instances evidence as to infection
from previous cases of diphtheria was obtaned. In 73 cases the houses were occupied
by more than one family, in 24 by single families, and in 10 instances the cases were
in blocks of artizans' dwellings. In 56 the cases occurred in houses whioh were in
a satisfactory sanitary condition, in 25 in houses the condition of which was fair, and
in 26 in houses which were not satisfactory from a sanitarv point of view. The figures
as to the occupation and the sanitary condition of the houses in which diphtheria
cases occur were commented upon in my last Annual Report.
The cases certified as diphtheria in the metropolis numbered 7,916, as compared
with 6,482 in 1905, the attack-rates per 1,000 poulation being 1.6 and 1.3 respectively.
The deaths numbered 691. as compared with 546 in 1905, the death-rate being 0.14
and 0.12 per 1,000 population respectively.
ENTERIC OR TYPHOID FEVER.
The cases certified numbered 39, including one regarded as paratyphoid fever,
five which were not regarded subsequently as having been enteric fever, and one which
was looked upon as doubtful. With respect to the cases which were not enteric fever one
was erysipelas, one chronic nephritis and ulcerative endocarditis, and three were
stated to be not enteric or not notifiable.

The cases certified were at the rate of 0.3 per 1,000 population, as compared
with 0.3 in 1905, 0.4 in 1904, and 0.8 in 1903. With one exception, which was not
regarded as enteric fever the cases certified were all in patients over five years of age.
The deaths numbered 4, and the death-rate was 0.03 per 1,000 inhabitants, as