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with the removal of the patients to the Hospital, and the consequent
diminution in the number of persons treated in a room,
for, so far as I can ascertain, the proportion of removals to cases
was not greater than in 1882. Whatever the cause may have
been, it extended over the whole of London. Thus, in 1875-80,
the deaths in the Asylum Board's Hospitals averaged 120 per
1,000 cases admitted, whilst in 1881-5, the mortality was only
96 per 1,000 patients. As regards 1881 and 1886, I cannot
make a comparison, as the data for the latter years are not yet
published. The mortality from this disease, for the 40 years
during which I have paid especial attention to its statistics,
including the death-rates and the meteorological causes affecting
its fatality, has varied partly according to the diseases accompanying
or following the fever, and partly according to the
intensity of the poison, which varies very much. In some
epidemics if is not unusual to meet with frequent deaths from
this disease in a very short time after the attack, whilst in
others, as in 1886, this rarely occurred. In some epidemics,
during the fibrile or early stage, inflammation of the throat,
either internal or external, frequently occurred ; whilst in others,
during the latter stage, dropsy caused very many deaths. As
far as I can ascertain, deaths from these causes were not
common in 1886, and as there is an evident connection between
a particular kind of sore throat and bad drainage, I think we
may fairly assume that the milder type of the disease, and its
complications, are partly consequent upon the improved state of
the drainage. During the last seven years bell-traps have been
removed from as many as 11,311 premises, and yard gullies
substituted; 6,858 waste-pipes from sinks have been cut off
from direct communication with the drains; and 4,115 rain
water-pipes, the hopper heads of which were near to living or
sleeping rooms, have also been disconnected. There have also
been a water supply and apparatus provided for, or apparatus
repaired in, 5,364 closets during the same period, and a better
supply provided in 2,504 houses.