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The policy of removing those suffering from this disease has
been continued by the Metropolitan Asylums Board, and I have no
doubt that this removal has in many cases resulted in the saving of
life. Sometimes the pressure on the hospital has been too great,
and to ensure the removal of the most suitable cases the Board
issued a form which the officers of the sanitary authorities are
required to fill in before a case can be removed. This has done
much to ensure those children being taken away who are the least
likely to be able to get proper attention at home, or where the
house conditions are most unfavourable for proper isolation.
The deaths from scarlet fever, which were 9 in all, showed a
slight increase from the remarkably low number of 6 for last year;
but when one comes to compare these figures with a total of 80 in
1893, it is hardly necessary to dwell on the enormous diminution in
the mortality of the disease during the past twenty years. It is impossible
to say whether this is due to the prevalence of a less virulent
type of the disease than that which formerly existed, or whether a
new race of children has developed, able to resist first the attacks
of the disease, or who, if they should be so stricken, do not succumb.
It is not unlikely that both these factors are at work. The notifications,
although differing but little from the previous year, were 30
less than in 1903, and about 1,200 less than in 1893. It will be seen
that the fatality of the disease has declined in the last twenty years,
and for the last year the case mortality was only a little over 1
per cent. More notifications came from North Camberwell and
St. George's than elsewhere, South Peckham showed a great diminution
from last year, and, as usual, they were almost universally and
entirely among children over 1 and under 15.
There were a number of children notified from schools where
they had been examined in the ordinary course of affairs by the
school medical officers. They were all duly excluded from school,
and were for the most part put under the care of private doctors;
but in one case the mother point-blank refused to call a medical man,
as she stated her child was perfectly well and she could not understand
the reason of the exclusion. I visited the house, as there was
a question of infection arising, but could not say that the child was
suffering from scarlet fever, and therefore did not advise any action.
There was no notification of any other attack in this house, nor were
the great majority of excluded children mentioned above re-notified
by their own doctors. Following the school notification, the parents
in another instance called in a private practitioner, who asked me to
see the child with him. We both agreed that there was not sufficient
evidence to justify removal to hospital, which in the ordinary
circumstances we should certainly have advised, and no other child
was attacked in this house.
The deaths from enteric fever, which were only four during
1911, increased by one the last year; the number of notifications
rising from 29 to 33. Just the same as last year there were none
notified from Dulwich, and the majority of the notifications came
from North Camberwell, although there were two less than last year.