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treatment owing to the fact that the Iron Hospital in Gap
Road was used exclusively for Scarlet Fever patients, and,
allowing for a number of deaths occurring amongst such cases,
the actual mortality rate would, however, be somewhat higher.
Then for the past eight years, during which time the
present Isolation Hospital in Gap Road has been opened, the
average attack rate has remained the same, but the mortality
rate has dropped to 10 per cent., owing, no doubt, iu a great
measure to the use of anti-toxin and the complete isolation of
Diphtheria patients in a separate block of the hospital.
From Returns publishtd by the Metropolitan Asylums
Board it is clear that if any benefit is to be derived from the
use of serum it must be used as early as possible, and the
earlier it is given in the course of the illness the greater the
probability of recovery. The experience of the Superintendents
of the Board's hospitals is that, since the inception of
anti-toxin treatment, the death-rate from the disease has shown
a wonderful decrease. This coincides with the experience of
Wimbledon.
Enteric or Typhoid Fever.—During the year five persons
in five different houses were notified as suffering from this
disease, two being in Cottenliam Park Ward, two in Trinity
Ward, and one in St. John's Ward. One case occurred in
May, two in June, and two in September.
The attack rate is the extremely low one of .09 and the
death-rate .01 per 1,000 of the population. Not only is this
the lowest attack rate recorded in Wimbledon, but it is also
the lowest number of cases occurring since 1890, when the
population was but half what it is now.
In accordance with the usual procedure, the drains and
sanitary arrangements of the respective houses were tested,
but in only one instance were defects found. In this case the
existing conditions necessitated the re-construction of the
drains, w.c.'s, etc., and this work was subsequently carried
out in a satisfactory manner.
One patient, a nurse in a Poor Law Infirmary, undoubtedly
contracted the disease before coming to Wimbledon
after her summer holidays.
The origin of infection was somewhat obsctire, but in
three instances shell-fish or water-cress had been eaten by the
persons attacked, about the time which would agree with the
incubation period.
Puerperal Fever.—One case only was notified during the
year (last year there were three), this proving fatal. It
occurred in the practice of a registered midwife, and was
reported upon in detail to the Surrey County Council, the
Local Supervising Authority tinder the Midwives Act. She
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