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remission, and that without any payment from him. This seems
to me a most extraordinary parliamentary interference with my
professional knowledge and time. The Infectious Diseases Notification
Act has been useful in affording information as to
numerous cases of infectious disease, which otherwise would not
have come to my knowledge, so that the disinfection of the
rooms of the sick, and where necessary of their clothing, has
doubtless tended to prevent the spreading of these diseases. The
increase of work owing to this Act has been very large, and it
has been fairly met, but to a considerable extent at the expense
of the regular inspection of the houses of the poorer classes. In
1888, the year before this Act came into operation, 5,410 of the
houses were inspected ; but in 1890, 4,389 only were inspected, a
falling off of about 20 per cent. The number of certificates received
from the Medical Attendants of the sick was as follows:—For
scarlet fever, 1,171; for small pox, 1; cholera, 0: diphtheria,
428; membranous croup, 38; erysipelas, 191; typhus, 2; enteric
or typhoid fever, 201; and puerperal, 29, making the large total of
2,081 cases of infectious diseases certified in the year. This is not
in excess of the number I expected when the Act was passed.
The deaths from these diseases were as followsFrom scarlet
fever, 55; diphtheria, 62; croup, 42 (this included all cases of
croup); erysipelas, 15; typhus, 0; typhoid or enteric, 34; and
puerperal, 13. The mortality from scarlet fever was not large,
viz., 47 per cent. of the cases reported, whilst from enteric fever
it reached 17 per cent, and from puerperal 47 per cent. A
comparison between the number of certificates and of deaths will
be a useful study in future years, as the death rate of infectious
diseases varies to a great extent with the number and severity of
the complications. On receipt of a certificate of scarlet fever a
circular is sent to the parents, and as soon as the post-card is
received back to the effect that the patient is no longer infectious,
or on removal of the sick to a hospital, the rooms, clothing and
bedding are disinfected by an officer of the Board. A similar
circular is sent as regards diphtheria, and the premises disinfected
at the proper time. On the back of the circular (re
diphtheria) some instructions are given as to the sanitary
management of the case. Copy of circular is appended.