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above the average. Thirty-two of these deaths were of Infants under
one year. The deaths from diarrhoea were considerably in excess in
the Metropolis of the average rate in the preceding 10 years.
Whooping Cough was the assigned cause of 11 deaths, against 27
for 1898. The whooping cough death rate in London was 0.38 per
1,000; the mean rate in the 10 years, 1889-98, having been 0.54 per
1,000.
Erysipelas. —Fifty-one cases of this disease were registered during
the year; there was no death from this cause.
Puerperal Fever. —Two deaths were registered from this cause, and
five cases in all were recorded. Infection by the agency of the Midwife
was thought to be traced in certain instances. A Bill for the Registration
and Control of Midwives is now before Parliament, but owing
to the pressure of other matters appears at present to have little chance
of passing.
Notification of Infectious Disease. —The total number of certificates
received was 491, for notifying which the sum of £59 14s. was paid to
Medical Practitioners. This amount is recouped to the Vestry by the
Asylums Board, out of the Metropolitan Common Poor Fund. The
total number of cases removed to fever hospitals for treatment was 291.
Upon receiving notification of a case of infectious disease, the
premises where the case occurs is visited within a few hours, particulars
taken of the number and circumstances of the family, the state
of accommodation of the patient, the number of lodgers, if any, in the
house, the school, milk supply, and laundress of the family, and of the
movements and history of the patient for some days previous to the
attack. Every endeavour is made to remove suitable cases to hospital;
the parents of children in the affected house are warned not to send
them to school, and the head teachers of the school are notified of the
illness. In the case of Diphtheria and Typhoid Fever, an Inspector
subsequently makes an examination of the drainage and water supply,
and reports any defects discovered. Lastly, on receipt from the
Medical Attendant of notice that the patient has recovered, or upon his
removal to hospital, the clothing, &c., and the premises, are thoroughly
disinfected, and the latter ordered to be cleansed and whitewashed.