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41
Parish of Clapham.
there was great difficulty in effecting the prompt removal
of patients owing to the want of sufficient hospital
accommodation. This difficulty was not experienced to
the same extent in 1894.
Diphtheria.—The number of cases reported was 125,
and 1 of membranous croup, against 108 and 6 in 1893.
The increase was not, therefore, so marked as between
1892 and 1893, when the number nearly doubled. The
number removed to the isolation hospitals was 61. The
number of deaths was 39, giving a case mortality
of 209 per cent. Amongst those removed to hospital it
was 39.3, and in those remaining at home 23 per cent.
The mortality has thus been very great, greater even than
in 1893. The reasons for its increasing prevalence in
Clapham, as in the metropolis generally, are, therefore,
of very great importance. With regard to insanitary
conditions, it cannot be said that generally anything very
greatly amiss has been found at the homes of the
sufferers. Out of the 126 cases, in 31 houses some
drain defect or other unhealthy condition was found, in
some instances it was dampness, but often it was not of
a serious character. In the other 92 houses no fault
could be found. Then, too, the cases have not occurred
especially in those streets where there is most crowding
of the people together, and where, from the character of
the population, the surroundings are most dirty, in fact,
the disease seems to have rather avoided certain areas of
thi3 character.
Another opinion, now commonly held, is that diphtheria
spread is chiefly due to direct infection from patient to
patient without the intervention of insanitary surroundings.
There can be no doubt that there is much
truth in this opinion. It is, therefore, considered highlyprobable
that the congregation of children in schools,
especially, of course, the public elementary schools, has