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Only five cases of small-pox were admitted during the
year, or scarcely more than one per 1,000,000 of the
population.
Mistaken Diagnosis.— No fewer than 1,488 patients, or
7.2 per cent. of the total admissions, were, after admission,
found to be not suffering from the diseases mentioned in the
medical certificates upon which they were removed to hospital.
Amongst the 603 cases wrongly certified as scarlet fever, there
were 73 of measles, and 129 of tonsillitis : 120 had no obvious
disease. Amongst the 600 cases wrongly certified as diphtheria,
there were 34 of measles and 450 of tonsillitis. Amongst
the 265 cases wrongly certified as enteric fever, there were 12 of
influenza, 55 of pneumonia, and 6 of bronchitis. Of the 6
patients admitted to the hospital ships, one was not suffering
from small-pox. Thirty-six patients were taken to the
London wharves, of whom 31 were not suffering from smallpox.
"It is evident," the committee observe," that the
ordinary practitioner in London practically never sees either
small-pox or typhus."
Annual Admissions 1870-98 : Reduction in Mortality.—
A return is given (on page 32) showing the annual
admissions and deaths of patients at the Managers' fever
hospitals, with the mortality per cent. since the establishment
of the first hospital in 1870, together with extracts from the
Registrar-General's annual summaries, showing the annual
mortality per 1,000 persons living of the population of the
metropolis, from scarlet, typhus, and enteric fevers, and diphtheria.
The decreasing percentage of the mortality amongst
scarlet fever patients treated in the hospitals continues to be a
noticeable feature. More noticeable, however, is the decline
in the percentage mortality amongst diphtheria patients; from
40.74 in 1889 (when practically diphtheria cases were first
admitted) to 29.29 in 1894, to 22.85 in 1895 ( when the antitoxic
serum was first adopted) to 17.69 in 1897, to 15.37
in 1898 ; and, it may be added, to 13.6 in 1899.