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43
fore, that a circular letter should be sent to the parents of
pupils for their information; but this course was not adopted.
Such a communication, if systematically made at the beginning
of an epidemic of any infectious disorder, would probably be
the means of saving many lives: it would certainly have the
effect of checking the spread of measles in the only practicable
way short of closing schools.
SCARLET FEVER.
Scarlet fever, which had been the cause of 28, 26, 16, and
36 deaths of parishioners in the preceding four years
consecutively, proved fatal to 51 persons in 1893, or 27 more
than the corrected decennial average. Five only of the deaths
belong to the Brompton sub-district. Forty-one deaths took
place at public institutions without the parish, to which 568
cases were removed, and 12 at the homes of the deceased. The
case-mortality was 3.1 per cent. in home-cases and 7'2 per
cent. in hospital-cases. The cases notified were 957, compared
with 375, 323, and 715, in the preceding three years
respectively, viz., 570 in North Kensington, i.e., North of the
Uxbridge Road, and 387 in South Kensington.
Scarlet Fever in London.—The deaths from scarlet
fever in London as a whole were 1,596, and 449 more than the
corrected decennial average number. Nine hundred and twentyone
of the deaths, or 58 per cent., occurred in public hospitals
or infirmaries. The total deaths corresponded to an annual
rate of 0.37 per 1000 population, this being 0.10 in excess of the
decennial average. The notifications, after correction for
duplicate returns, were 36,901, and 9,805 more than in 1892.
The case-mortality was about 4 3 per cent., the rate in 1892
having been 4.2.
The following table shows the progress of the epidemic,
both in the parish and in the metropolis as a whole, as evidenced
by the number of the cases and the deaths recorded
in the thirteen successive periods covered by my four-weekly
reports,