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increased use of antitoxin in cases of the disease as well as a
measure of prevention. Of recent years another very potent agent
in the reduction has been the calling into aid of bacteriological
methods, whereby the throats of children who have suffered from
the disease and who have been nursed at home can be examined in
this way before being allowed to return to school. I believe that if
the rule requiring such a certificate before return to school were
more widely applied, there would be a still further reduction of
the disease. The rule of the Council to supply antitoxin free to the
medical practitioners who require it is still being carried out, and
during last year 60 bottles were distributed. The incidence so far
as relates to fatal cases showed a considerable increase in South
Peckham, the other districts remaining nearly the same, with the
exception of a very marked decrease in St. George's. In the number
of notifications there was a decline in the two Peckham divisions.
Seven deaths were put down to enteric fever, a reduction of 2
from 1907. There were, however, less than half the number of notifications
received during the past year, St. George's alone showing
any increase.
In 7 instances there was a history of the patient having
eaten some form of shell-fish, while one man obviously contracted
the disease away from Camberwell.
Considerable interest has recently been aroused on the subject
of this disease by the fact that persons may apparently have
recovered from it and yet be passing virulent bacilli from the
kidneys and bowels. The subject is of great importance, as it explains
single cases which were previously difficult to account for, and it
has been the means of giving an explanation of epidemics in isolated
districts. The Government is at present making an investigation
into such cases, and has invited the co-operation of the various
medical officers of health to take specimens from patients who at
the time of their discharge from the hospital were passing these
bacilli.
Next year I hope to give some account of the investigation.
Measles and whooping cough both showed a very large decrease
on the two previous years, and in the case of the former there
being 50, and in the latter 57 less than the previous year. Too
much must not be set on this, for the years always show considerable
variation, and it is probable that in 1909 the deaths will again
reach, if not exceed, the number of former years.
There was a diminution specially noticeable in the case of the
poorer districts. As is usual, all deaths, except 7, occurred in
persons under the age of 5 years.
During the year a careful watch has been kept in all instances
where there have been children of tender years attacked, and where,
in conformity with the rules of the Education Department, any older
children who had previously, perhaps even in infancy, suffered from
measles were allowed to continue attendance at school.
This course has always seemed to me as theoretically a wrong
one, but I am bound to repeat what I said two years ago, viz., that