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to Poplar, and 14 deaths to Bromley, giving respective death rates of
0.17 and 0.18 per 1000 living.
I will not criticise the statement as to whether the eating of
oysters is a cause of Typhoid Fever, but I would most strongly
advise everybody who partakes of water.cress to see that it is well
washed, as it has been stated that several cases have occurred after
partaking of this popular green stuff, which had been grown in
polluted water. I think the same advice for obvious reasons applies
to the eating of celery.
DIPHTHERIA (INCLUDING MEMBRANOUS CROUP).
The notified cases of Diphtheria (including Membranous Croup),
were much less during 1894 than in 1893, as the figures stated below
will show.
I have no doubt that a very large percentage of cases notified as
diphtheria are not such. To what extent non.diphtheritic cases are
contagious I am not prepared to state; but I am of an opinion that
they are due to insanitary conditions like the graver disease. A
very mild affection of the throat may be true diphtheria; but, on
the other hand, a throat covered with membrane may contain no
diphtheric bacilli, and would be notified as diphtheria.
In my annual report for the year 1893, I stated that the drought
during the exceptionally hot weather was the cause of a large number
of cases, on account of the gullies in the streets and elsewhere
becoming untrapped and allowing the sewer gas to escape. My firm
conviction is that diphtheria is due to emanations, either from sewers
or drains, or from ground polluted with sewage. Sewers should be
ventilated at an elevation instead of on a level with the pavement,
and the houses should be the means by which shafts should be
carried up, and no owner should be allowed the right to refuse. No
grating should be permitted in the roadway level, even if there be
up.shafts, inasmuch as the latter may become down.shafts.