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from Diphtheria is very seriously disturbed by the existence of
hospitals in certain of the areas. In Hampstead, for example,
176 deaths from Diphtheria were registered in 1897; most of
these occurred in the Metropolitan Asylums Board Hospital, to
which the patients had been admitted from other districts, and,
after distribution of Institution deaths, only 17 remained which
were those of persons belonging to Hampstead sanitary area.
Similarly in Fulham sanitary area 155 deaths from Diphtheria
were registered, most of these being Hospital cases imported from
outside districts, only 63 properly belonging to Fulham. Hackney,
St. Martin-in-the-Fields, City of London, Holborn, St. Olave
Southwark, Wandsworth, Greenwich and Lee, are also instances
of sanitary areas whose registered Death Rates from Diphtheria
are enormously increased by the presence of Hospitals. On the
other hand, Kensington, Chelsea, St. Marylebone, St. Giles,
Clerkenwell, St. Luke, Bethnal Green, St. George-in-the-East, St.
George Southwark, Newington, Bermondsey, Battersea and
Camberwell, may be mentioned as examples of the opposite kind,
where the effect of distribution has been to more than double the
Diphtheria Death Rates of those areas by the inclusion of deaths
occurring in Hospitals outside their own boundaries.
"Among London sanitary areas the lowest Death Rates from
Diphtheria, after distribution of Institution deaths, were 0•13 in St.
James, Westminster, 0•17 in St. Olave, Southwark, 0•19 in St.
Giles, and 0•21 in Strand; the highest rates were 0•65 in Bethnal
Green, 0•66 in Camberwell, 0•71 in Poplar, 0•73 in Clerkenwell
and in Bermondsey, and 0•80 in Woolwich.
"The following table shows the Death Rates from Diphtheria