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34
to hospitals of the Metropolitan Asylum Board, and to the
London Fever Hospital, &c., leaving one hundred and eighty-seven
which were treated at home. The deaths in hospital, to which
the worst type of cases is generally removed, were twenty-two
or just 3.5 per cent. of cases, while of the cases treated at home,
the majority of which were of a very slight nature, involving
perhaps only scarlatinal sore throat, 3.2 per cent. died.
One thing is certain, that the generally improved sanitary conditions,
including early removal of cases which could not be
effectively isolated, have reduced the mortality of this disease
to a remarkable extent.
Diphtheria
and
Membranous
Croup.
Seven hundred and ninety-one cases of this disease
were notified during the year, four hundred and
eighty-one were removed to hospital, the remainder,
three hundred and ten remained at home.
Of the cases removed to hospital, seventy-five died, giving a
hospital mortality of 15 per cent., the worst and most urgent
cases being removed thereto. Of the cases remaining at home,
forty-five died, being at the rate of 14 per cent. Some
of these cases were of a doubtful nature, being probably cases of
ordinary sore throat.
A glance at Table XIII will show the number of fatal cases of
Diphtheria at home during the last eleven years. They were in
1888, twenty-two; 1889, twenty-one; 1890, twenty-seven; 1891,
thirty-five; 1892, twenty-eight; 1893 ninety; 1894, sixty-seven;
1895, sixty; 1896, fifty; 1897, fifty-two; and in 1898, forty-five
or just half the mortality from this disease in 1893.
In the report for 1897 I observed "This disease appears to
have become endemic in London. It has a tendency to shift
from locality to locality," and in consequence of the incidence of a
number of cases in No. 2 Sanitary district, I was directed to
report thereon, and subsequently upon the undue incidence of
this disease in districts No. 4 and 6.