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is almost certainly attributable to the more extended use of the antitoxin
treatment in this disease. A case mortality so low as 10.6 per
cent, is certainly novel in the history of this disease in London. The
high case mortality of enteric fever in Chelsea is probably due to the
importation into the parish of unusually severe cases from outside its
boundaries.
Removals to Hospitals.—Table X. exhibits the removals of patients
suffering from scarlet fever, diphtheria, and enteric fever, from their
homes to hospitals, in each of the ten years, 1890-99, expressed as
percentages of the total number of cases notified.

The percentage of removals of cases of all three diseases is in
advance of any previous year, showing that hospital treatment continues
to advance in favour amongst all classes of the community.
Measles.—There was no epidemic of measles in 1899, but the
expected visitation, now regularly recurring every other year, is already
making itself felt in the home district at the moment of writing. It
is a matter for regret that the London County Council has not seen its
way to apply by order the "prevention" sections of the Public Health
(London) Act (Sections 58—74) to measles, so that the same precautions
may be rendered compulsory by the public with regard to this disease,
as are required for the far less fatal malady, scarlet fever. This Vestry
urged the desirability of so doing upon the Council, and it was the
Council's own suggestion that it should be done; but, so far as I
am aware, no action has been taken.
I have recently addressed a letter to all school teachers in the
home district, urging the importance, during the progress of an epidemic
of measles, of excluding all children from school, who show any traces
of nasal and faucial catarrh, which are often the early and very
infectious stages in the development of attacks of measles.
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