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that she had not felt well since May 14th ; but when she was visited by the sanitary inspector
on May 18th, she was up and dressed, and made no complaint of illness. The inmates of the
other tenements appear to have held no communication with the family, and all escaped.
The notifications of typhus in London, as a whole, were 20, the deaths 4, and one below
the corrected decennial average.
Simple continued fever.—Notifications in the borough, 8 ; deaths, none. In London, as a
whole, 48 cases were reported from this cause, and 7 deaths were registered, being 8 below the
corrected decennial average.
BIARRHŒA.
The Registrar-General has recently issued to medical practitioners a memorandum with
respect to certification of deaths from diarrhoea, as follows: —
" The Royal College of Physicians of London, in response to an earnest appeal for its
authoritative guidance concerning the certificates of death from diarrhœa, has now expressed
an opinion which, if loyally adopted by medical men throughout the country in granting
certificates of death, will greatly improve the national records of mortality from this disease.
The following is an extract from the proceedings of the College, dated January 25th, 1900: —
" The Royal College of Physicians is convinced, after careful inquiry:—(a) That
various unauthorised and misleading terms, such as ' gastro-enteritis,' ' muco-enteritis,'
' gastric-catarrh,' etc., are now commonly employed to designate the disease officially
known as ' epidemic diarrhœa,' whereby its specific character is in danger of being
ignored, and great confusion ensues; (b) that the present confusion of terms renders it
impossible to determine accurately either the prevalence of the disease in special places
and at special times, the extent to which it influences the public health, or the effects
produced by sanitary measures; (c) that there is a widespread objection on the part of
medical practitioners to the employment of the term ' diarrhœa ' in certifying the cause
of death, probably because the term is generally held by the public to imply a mild
disease, insufficient by itself to cause death.
" The College, therefore, has sought to discover as an alternative for the authorised
term (epidemic diarrhoea) some other name, which, whilst equally accurate, should
convey to the public the idea of a more serious affection. But the College regards it as
essential that the idea of specificity, intended to be conveyed by the term ' epidemic,'
should be retained.
" As the result of much deliberation, the College has agreed to authorise the use of
the term ' epidemic enteritis ' (or, if preferred by the practitioner, ' zymotic enteritis'), as
a synonym for epidemic diarrhœa. The College has further decided to urge upon
practitioners the entire disuse, in medical certificates of death, of such terms as ' gastroenteritis,'
' muco-enteritis,' or ' gastric catarrh,' as synonyms of epidemic diarrhœa."
Hitherto, deaths from the diseases specified in the above memorandum, etc., have been certified,
in the majority of cases, under the heading " diarrhœa in future a more careful classification of
such deaths may be anticipated, and I certainly think it will be the duty of the medical officer of
health, so far as practicable, to discard the use of the term " diarrhœa," as being the description
of a symptom only, substituting therefor one or other of the terms recommended.
The several diseases included in the expression diarrhœa were the causes of 115 deaths
in Kensington, compared with 112, 101, and 105, in the three preceding years; 109 in the Town
sub-district and 6 in Brompton ; the corrected decennial average being 99. Of these deaths,
93 took place in the twelve weeks ended October 5th; viz., 47, 36, and 10, in the three successive
four-weekly periods: one hundred and two were of children under five years of age, including
91 under one year.
The deaths in London, as a whole, from this cause were 3,888, and approximately 456
above the corrected decennial average (3,438).
INFLUENZA.
Twenty-eight deaths were registered from influenza, compared with 70, 103, and 85, in
the three preceding years: 20 in the Town sub-district and 8 in Brompton. The deaths in
London, as a whole, from this cause, were 664, compared with 679, 1,817, and 1,950, in the
three preceding years.