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scarlet fever.
Daring the 53 weeks ended Saturday the 3rd January, 1903, the number of scarlet fever
notifications, excluding duplicates, was 202; 90 in Bloomsbury and St. Giles, and 112 in the
Holborn Sub-District. All except three were removed to Hospital. The decennial average for
St. Giles and Bloomsbury was 141, and for the Holborn Sub-District 151. There were 8 deathsregistered
as due to this disease, 6 belonging to Bloomsbury and St. Giles, and 2 to the Holbora
Sub-District.
The disease was not very prevalent in the Borough last year, and the weekly fluctuations
in the two divisions of the Borough were more marked than usual.
Reduction of the Stay of Patients in Hospital.
I read a Paper at the meeting of the Metropolitan Branch of the Society of Medical
Officers of Health, on December 19th, 1902, in which I prepared statistics of the average
detention of scarlet fever patients in the hospitals of the Metropolitan Asylums Board, and shewed
that this period was longer than in most of the Provincial hospitals, and in hospitals in America
and on the Continent. I then gave reasons and evidence for the adoption of measures that in
the opinion of many experts, would reduce the average period of detention of patients in hospital,
not only to the advantage of the patients but also of the parents, the public, and the ratepayers.
It was generally considered that the conference with the Medical Supeintendents of the
hospitals of the Metropolitan Asylums Board, at the reading of the Paper and at the adjourned
discussion thereon, would result in increased co-operation, and a reduction in the average period
of detention of patients in hospital.
The Paper was published in " Public Health," February, 1903.
diphtheria.
The number of cases of diphtheria notified was 113, of which 44 belonged to Bloomsbury
and St. Giles, and 69 to the Holborn Sub-District. All but 6 were removed to hospital. The
decennial average for the two divisions being 55 and 92 respectively. There were 11 deaths from
this disease, 5 belonging to Bloomsbury and St. Giles and 6 to the Holborn Sub-Division. The
mortality was only 9.7 per cent.
The disease was not very prevalent during the year, and as in scarlet fever the weekly
fluctuations of the disease were more marked than usual.
enteric fever.
39 cases were notified, the same as last year, of which 24 belonged to St. Giles and
Bloomsbury and 15 to the Holborn Sub-District, the decennial average being 26 for each division34
of the 39 cases were removed to hospital, and two of them were returned as not enteric fever.
The number of deaths was 6,5 belonging to St. Giles and Bloomsbury and 1 to the Holborn
Sub-District.
In four of these cases there was strong evidence that the disease was caused by eating
shell-fish. One of them was a boy aged 13, who had been at a school outing at Southwick for a
fortnight, and had also visited Southend-on-Sea. Of the boys who went to this outing 18 were
attacked with enteric fever, and all of them had eaten cockles, or mussels, or both.
Many outbreaks of enteric fever have been proved to be due to sewage contaminated
shell-fish. In many cases oysters and other shell-fish which have been laying in beds where there
was a probability of sewage contamination have been proved on bacteriological examination to
have been so contaminated. During December, 1902, and January, 1903, oysters from various