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and even for years after recovery from the disease, and several
outbreaks have been traced to these carriers. It has been
found that the bacilli disappear from and reappear in the
feces in a very irregular manner, so that a single negative
examination of them is inconclusive, and with the view of
ascertaining what proportion of patients remain infective after
recovery and the length of time the infectivity continues, Dr.
Theodore Thomson arranged last year, on behalf of the Local
Government Board, that when a patient was discharged from
a hospital of the Metropolitan Asylums Board who was excreting
typhoid bacilli, the Medical Officer of Health should
send samples of his stools and urine monthly, during the first
six months after discharge, to the Lister Institute forexamination,
and should all prove negative, that a further sample of
each should be sent at end of'the next period of six months, and
this year the scheme lias been extended to include all patients
discharged from the Asylums Board's hospitals after recovery
from enteric fever. In 1909 one patient, a man aged 59, was
reported to be still excreting typhoid bacilli from the bowel,
but five monthly examinations proved negative, as did three
examinations of the excreta of a girl, aged 5, who had been
notified by the Medical Officer of Health for Chelsea as a
"carrier" who had moved into Fulham.
Errors of Diagnosis in Notified Infectious Diseases.
Of the patients certified as suffering from scarlet fever 28,
or 5.5 per cent., from diphtheria 38, or 11.8 per cent., and
from enteric fever 6, or 14.6 per cent., were subsequently
ascertained not to be suffering from those diseases.
Puerperal Fever.
Thirty-four cases of puerperal septicaemia, or 8.1 per 1,000
births, were notified, of which 13, or 3.1 per 1,000 births, proved
fatal.
The number of cases in 1909 was much higher than in any
previous year, and it will be seen on reference to Table XV.
thajt there has been a marked increase in notified cases since
1905, the notifications in the five years 1905-1909 being twice
as numerous as in either of the three previous quinquennia.