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45
On comparison of these tables we learn, that the
notifications in 1893 exceeded those in 1892, by 239 in
Kensington, and by about 10,000 in London; and that the cases
admitted into the hospitals in 1893 were also in excess—by
132 in Kensington, and by more than 1,600 in London.
The deaths, moreover, in 1893 were also in excess—by 15
in Kensington, and by 422 in the metropolis as a whole,
compared with the corresponding totals in 1892. The tables
further show that in both years the notifications were fewest
at the beginning of the year, and that the maxima wereattaini>d
in the 37th-44th weeks, September 10th to December 1st.
In 1892 scarlet fever began to assume large proportions in the
period dealt with in my fourth four-weekly report, beginning
March27th; in 1893 in the fifth four-weekly period, beginning
April 23rd. In the first quarter of 1892, however, the disease
was not epidemic, whereas in the first sixteen weeks of 1893
there was a continuance only, of the decline in the epidemic
prevalence which had set in in the previous November, and
which ended in April, when a severe recrudescence commenced.
In 1892 the notifications in London in the last fourweekly
period were 1,968; in the corresponding weeks in 1893
the number was 2,215. In both years the hospital accommodation
at the disposal of the Asylums Board proved inadequate
to the requirements of the Metropolis. More so in 1893,
however, than in 1892; for whereas on November 5th, 1892,
there were so many as 4,067 persons in hospital at one
time, the highest number for whom accommodation was
found at any one time in 1893, did not exceed 3,183. But, as
I pointed out in my ninth four-weekly report (September
11th) the number of cases in hospital furnished no true indication
of the state of the epidemic; for, the accommodation
being totally inadequate, all the hospitals were continuously full,
and not a day had passed for many weeks but patients had
to be refused admission, from this parish and others, for want