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added that "if this be so, such increase is not likely to be temporary,"
and they pointed out that since compulsory notification
had been in practice, the number of patients received into the
hospitals "has rapidly increased and is still rapidly increasing."
It was stated that of the scarlet fever cases
notified in London in 1890, the Managers received less than
42 per cent.: that the proportion of admissions to notifications
rose in 1891 to 46 per cent. and to 48 3 per cent. in 1892, and that
the proportion further rose to nearly 55 per cent. during the first
four months of 1893, the accommodation at that period being
adequate. "It was clear from these figures that the need for
extra accommodation was becoming greater and more urgent."
The outlook therefore was "most gloomy," having regard to
the fact that the cases in the spring are at a minimum,
the maximum not being attained until autumn. The
minimum in 1893 (1,880) was reached on the 18th March, and
was "a number practically double the average minimum of
the preceding three years," and 743 more than at the
corresponding date in 1892, in which year the maximum
(4,001) was reached on the 17th November. It followed,
from the statistics given, that the Managers might be
required to provide beds in the autumn for 4,832 scarlet
fever patients at one time; or, "if the proportion between
highest and lowest be taken," on the figures of 1892,
for "no less than 6,334." It was pointed out that by great
exertions in the time of the most severe pressure, the accommodation
in 1892, had been brought upto 4,628 beds. Sincethen
not only had diphtheria required a larger provision of accommodation,
but "the outbreak of small-pox swept away at one
stroke the 836 beds which were available at Gore Farm in the
Autumn of 1892;" whilst "certain other wards were not now
available owing to building operations and to other causes."
The Managers stated that in these circumstances they could
not possibly take in more than 3,434 cases of fever of all
kinds. The number of fever patients under treatment at the
date of the letter was 2,533, " although it was only seven weeks