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although that of the deaths shows the manner iu which the
disease was spread about, more markedly than the other. Of
course all the houses in which deaths occurred are noted on
both maps, although they are not distinguished from the cases
by a different colour.
The cause of the disease was ascertained only in a few
cases. In two only was it traceable to persons coming from the
Hospital. In both cases the disease appeared in houses three
days after children treated in the Hospital returned home. In
one patient there was a slight discharge from the ear, but in the
other there was nothing to account for it. Considering the
number of cases taken to and treated in the Hospital, and
the time for which this disease may remain infectious in persons
who have suffered from it, there is every reason to be satisfied
with the care ordinarily taken to retain patients for a sufficiently
long time after the fever has disappeared.
Typhoid or Enteric Fever.—The number of cases of this
disease has always been rather large in this district. In 1886
there were 66 cases reported, including 53 deaths, so that very
few non-fatal cases were brought to my knowledge. Indeed, if
it had not been for the copies of the certificates of deaths,
forwarded to the Board by the Registrars, I should have been
in almost entire ignorance of the residences of the patients, and
consequently unable to enquire into the sanitary state of the
houses. As regards these, a very careful examination was
made, and in 20, some sanitary defect or another was discovered;
whilst in 46 the sanitary arrangements were good. The defects
found in 12 houses consisted of either the sink waste-pipes
being in direct communication with the drains, except for the
intervention of a bell-trap; or the head of a rain-water pipe
being near to a bedroom window. In 8 houses there were
defective water-supply apparatus or defective paving, and in 2
houses there were 4 cases of the disease without any sanitary
defect being discovered on examination.