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15
officers employed in the Ambulance Department of the Asylum's
Board; but it would be better in future, if unfortunately a similar block
should exist, that only those cases should be removed whose removal
is requested by the Medical Officer of Health, and as far as possible
that priority should be given to cases as suggested by him, as, knowing
the circumstances and surrouudings of all the cases in his district, he is
in a position to decide what cases are really the most urgent; as it was,
the least urgent were sometimes first removed, and in one
instance a case was removed in spite of the Acting Medical Officer
of Health having telegraphed to the Asylum's Board stating that he
considered the case properly isolated and that other really urgent cases
were awaiting admission.
Mortality.—Of the 445 cases admitted into Hospitals, 25 or 5.6
per cent, proved fatal; among the 256 cases treated at home there
were 8 deaths, a mortality of 31 per cent.; the mortality for all cases
being 47 per cent. The death rate from the disease per 1000 living
was 0.32, the rate for the whole of London being 0.37. and the average
rate for the past ten years in London being 0.29.
The case mortality shows that the disease though very prevalent
was of a mild type, as the average mortality in the Asylums Board's
Hospitals for the ten years ending 1892, was 9.3. The difference
between the mortality of the cases treated in the Hospitals and of
those treated at home was not so marked as usual: in 1892 the
mortality among 13093 patients admitted to the Board's Hospitals was
6.4 per cent.; while of 140C2 cases treated, only 2 3 per cent. died. The
difference has been described as being partly due to the worse nourished
condition of the cases admitted, but it must also be remembered that
cases are sometimes admitted in a practically moribund condition. The
question of the influence on the mortality from the disease of massing
together large numbers of sufferers has not yet been determined; but Dr.
Caiger, the Medical Superintendent of the South Western Hospital, has
drawn attention to the occurrence of Secondary Diphtheria among Scarlet
Fever convalescents on several occasions when the wards were more
crowded than usual, the floor space on these occasions being reduced
from 144 to 105 square feet; and in view of the new Hospitals about
to be erected, these facts should be borne in mind, for though an outcry
has been raised in some quarters about the alleged excessive cost of