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Sub-district of Putney and Roehampton.
63
followed in one case. The case mortality was only 1.2 per
cent., while the case mortality occurring in the Asylums
Board Hospitals was 4 per cent. The mortality in this
sub-district from Scarlet Fever was equal to only .04 per
1,000 of the population living, while that of London generally
was .21 per 1,000. These figures show that the
epidemic from which we suffered was of an extremely mild
character; so mild indeed was it that in many cases children
were allowed to go about by their parents in ignorance
of the fact that they were suffering from any serious
disease. A case was notified to me as having occurred in
a certain house let out in flats. When the inspector made
the usual enquiries he ascertained that the child had been
playing a short time before with children occupying
another flat in the same house, and that they had not been
very well. On investigating the condition of these children
I found several of them desquamating freely after a
mild attack of scarlatina, and one suffering from kidney
complications as doubtless the result of improper exposure.
In another case a child was brought to me by the
teacher of the girls school, who was suspicious of her condition.
I found her desquamating also freely in her hands.
She had been attending school in this condition. It would
indeed be a matter of surprise if under these conditions
the disease did not spread. Happily, I have always found
in the prevention of the spread of disease the sanitary
authorities have most useful auxiliaries in the teachers of
the National Schools. They have a very intelligent knowledge
of the prominent symptoms attending the common
infectious diseases, and let us know when their suspicions
are aroused in regard to any case. By their help in this
way we are enabled to limit the dissemination of disease.
During the year, the first case occurred in which it
was necessary, in my opinion, to apply to the magistrate
for an order for compulsory removal to hospital of a child