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18 SEPTIC DISEASES.
The seasonal distribution of the cases in the Borough was somewhat anomalous. As a
rule, more cases are recorded in the second than in the first half of the year, and there
is what is termed an autumnal increase in the disease. Last year there were 20 cases
reported in the first six months (Table 12), as compared with a quinquennial average of 12
and 9 in the second, the average being 27. More than half (13) of the 20 cases in the first
two quarters of the year were recorded in the second quarter.
In comparison with 1908 (Table 7) the cases reported last year showed increases in four
Wards, viz., Maida Vale, Westbourne, Church and Lancaster Gate, East, the greatest
proportional increases being noted in Westbourne and Lancaster Gate, East.
Of the 29 cases reported, 5 proved to have been erroneously diagnosed, equivalent to 17.2
per cent. of the whole, the average proportion for the five years being 12.5. The Widal
reaction was resorted to in 11 instances, negative results being obtained in four cases. Two
of those four cases are included in the five "errors," and if the other two be so dealt
with, the proportion of erroneous diagnoses during the year becomes 24T per cent. It must
be observed, however, that failure to obtain the Widal reaction does not necessarily mean that
the patient is not suffering with enteric fever, and hence the smaller proportion of errors
(viz., 17.2 per cent.) is probably the more correct. In 8 (of the 24 correctly diagnosed) cases,
the infection was contracted outside the Borough, there being also an undetermined number
of patients who partook of food (the commonest channel of infection) beyond the Borough
limits, whose cases are not classed as "imported." Enquiries as to the origin of infection in
isolated cases of this disease are very unsatisfactory and almost always unsuccessful. In only
three instances was any suggestion obtained as to the possible sources of infection, viz., mussels
and (or) watercress, periwinkles, and a contaminated surface well (one case each). Secondary
cases occurred in two households during the year.
Twenty-four cases (including 4 errors) were removed to hospital last year, constituting
72.4 per cent. of the total, as compared with an average of 71.4 per cent. during the
preceding five years. (Table 14.) Three cases terminated fatally, 2 in hospital and
1 at home, the total fatality being at the rate of 12.5 per cent , 4 per cent. less than the
average. (Table 14.) The decrease in the fatality among home-treated cases was much
greater than that among patients removed to hospital.
According to the Departmental records, the mortality was at the rate of 0.01 per 1,000,
one-fourth of the mean rate for the previous quinquennium. According to the figures issued
by the Registrar-General, the mortality in the Borough was 0.03 last year, and the mean
0.04. The only district with a lower rate last year was Marylebone, while the rate
in Hampstead was the only one which exceeded the mean.
SEPTIC DISEASES.
Puerperal Fever.—Three (3) cases of this disease were reported during the year
as compared with 6 in each of the years 1908 and 1907. The morbidity rate per
1,000 persons was 0.01 last year, 0.03 in 1908, and 0.05 during the five years 1904-08. The
rates for last year in all the districts included in Table 5 were in excess of that in
the Borough.
Calculating the morbidity rate on the births registered during the year a rate of 0.10 per
cent. is obtained for last year less than half the mean (0.25), and notably less than the
corresponding rates in the circumjacent districts, with the exception of that in Marylebone,
which was 0.11. (Table 16.)