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87
of the Metropolis. These variations are without doubt due to some condition or conditions
common to the whole Metropolis. The yearly excess of the Shoreditch rate
as compared with that of London is due to the existence of conditions in Shoreditch,
which favour the prevalence of diarrhœa to a greater extent than is the case with
London as a whole; probably the density of the population and the large number of
births which yearly occur are the principal factors in determining the yearly excess
of the Shoreditch diarrhœal death-rate over that of the Metropolis.
During August I received information respecting two cases of suspected cholera.
One was the case of a man aged 35 years, who was received into the Holborn Workhouse
on August 22nd, at 12.30 a.m. On rising in the morning he had slight
diarrhœa which became worse and was accompanied by vomiting. When he was seen
by the doctor in the afternoon he was in a state of collapse. His condition, however,
improved during the night and when I saw him the next morning he was convalescent.
The results of bacteriological examination so far as Asiatic cholera was concerned
were negative. The other case was that of a man aged 60, a stationary engine driver
who lived and worked in Shoreditch. So far as could be ascertained he had not
partaken of anything likely to have caused his symptoms nor had he been away from
home for a considerable length of time previously. His illness commenced on the
morning of August 15th, and terminated fatally on August 20th, vomiting, diarrhœa
and cramps were present but there was no reason for regarding the case as other
than one of English cholera.
ENTERIC or TYPHOID FEVER.
The cases notified numbered 107, six less than in 1896.
The following table contains the number of cases notified in Shoreditch during
the vears 1890-96:—

Ot the cases notified in 1897, 103 were of persons aged 5 years and upwards.
The attacks, which shewed no special incidence in any particular portion of the
district, were at the rate of 0.85 per thousand inhabitants. The deaths of which 10
occurred in hospitals outside the parish, numbered 19, the death-rate being 0.15 per
1,000 as compared with 0.14 in 1896, and 017 in 1895. Of the attacks 17.7 per cent.