View report page

119
I do not expect ever again to see such a terrible death-roll
from scarlet fever in London. In 1880 the hospitals were in
operation ; the scarlet fever admissions, however, were under
2,000, and less than two-thirds of the number of deaths in
London from this cause; whereas in 1893, with a population
of 4¼ millions, the admissions were ten times as many as the
deaths, 56 per cent, of which took place in the hospitals:
the maximum number of patients in hospital at one time, in
December, was about 3,200. It is now admitted that the
demands of scarlet fever alone, are certain to require for their
satisfaction in the future, a number of beds far more than one
in the thousand of population, viz., 4,300. A further allowance
will have to be made for enteric fever and diphtheria.
The average annual number of deaths from enteric fever in the
ten years 1883-92, was 683. In 1893 the deaths from this cause
were 693, the notifications 3,363, and the admissions to hospital
544. The deaths from this disease in 1893 were fully up to
the decennial average; but speaking generally enteric
fever is markedly on the decrease in London. Diphtheria, on
the other hand, is much more markedly on the increase. The
notifications of this disease, which had been 5,907 in 1891,
were 8,064 in 1892, and no fewer than 13,026 in 1893: the
deaths for some years past, moreover, have exceeded the
deaths from scarlet fever. In 1891 they were considerably
more than double as many. In 1892, the deaths from this
cause were 1,885, the then highest number on record. Last
year the deaths were 3,265, or 1,669 more than the deaths
from scarlet fever, and 1,984 above the corrected decennial
average. The admissions to hospital, moreover, are becoming
more numerous: 722, 942, 1,312, and 2,349, in 1889, 1890,
1891, and 1892 respectively, they were 2,848 in 1893; many
persons, moreover, having been refused admittance for want
of room. It is manifest, therefore, that a considerable number
of beds will have to be set aside for these diseases, as well as
a small number for typhus and ill-defined forms of fever—the
average number of deaths from which in the ten years,
1883-92, was 78—and for isolation purposes.