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notification of measles in 1914 and the more complete notification of tuberculosis from 1914
onwards. On the other hand the Dispensary Staffs took over a large share of the visiting of
cases of tuberculosis after 1915.
The total number of patients removed to hospital was 3,091 during 1914-18, as compared
with 3,328 during the preceding five years. Bearing in mind the fact that over 4,250 beds in
the hospitals of Metropolitan Asylums Board were taken over for the Services, there was
very little interference with the isolation service of the Metropolis.
Disinfection.—The contractors (Messrs. Armfield & Son) were able to carry out this
work without interruption. The number of rooms disinfected by the Council's Staff and the
weight of bedding, &c., dealt with by the contractors are shown in Table XIV., Appendix.
Bacteriological Work.—The total number of specimens received by the Department
for examination was 3,380, or nearly 65 per cent, more than the total (2,354) for 1909-13.
The annual numbers of the more important specimens are shown in Table XIV., Appendix.
The diphtheria swabs numbered 2,699, an increase of nearly 59 per cent. The positive swabs (451) formed 16.7
per cent. of the total, and those yielding the "Hoffmann" bacillus,* 2.4 per cent. During 1909-13 the " positive "
swabs formed 20.8 per cent of the total examined, and the "Hoffmann,"† 5.2. The highest percentage (26'2) of
" positive " swabs was recorded in 1916 and the lowest (11'4), in 1914.
The enteric specimens—blood —numbered 43, as compared with 128 in 1909-13, showing a reduction of twothirds
(663 percent.). Positive results were obtained with 14 specimens (325 per cent.), as compared with 50
(39'0 per cent) in 1909-13 The highest percentage (41*6) was obtained in 1914 and the lowest (27'7) in 1915.
The specimens from tuberculous patients - sputum—1,074, as compared with 483 in 1909-13, show an increase
of 122"3 per cent. The " bacillus tuberculosis " was found present in 251 specimens, equal to 23 3 per cent, of the
total, showing a slight increase (2 0 per cent.) above the proportion observed (21.3 per cent.) in 1909-13.
The specimens examined for detection of the organism of cerebrospinal meningitis numbered 44 against 13
in 1909-13, an increase of 238 per cent. Of the 44, 6 (13 0 per cent.) gave " positive " results, whereas 3 (23 0 per
cent.) did so during 1909-13.
There were 20 miscellaneous specimens examined—with 11 "positive" results—during 1914 18. and 32—
with 13 "positive" results during 1909-13, the latter total, including 17 specimens of faeces examined in connection
with a small outbreak of dysentery.
Certain of the specimens examined for cerebro-spinil meningitis taken from apparently healthy contacts
were tested in the laboratories of the County Council and the Ministry of Health, all others at the Lister
Institute.
Schools.—The annual numbers of notices sent to the head teachers of the Public
Elementary Schools following the occurrence of infectious disease in school children's homes
are included in Table XIV., Appendix.
In Table 15 will be found the prevalence rates—for certain infectious diseases per 1,000
places provided—in the two classes of elementary schools, viz., the Provided (L.C.C.) schools

" P.A."— Patient attending School —" Scholars." " P.N.A."—Patient not attending School—" Contacts."
* This bacillus was reported present in the swabs examined during 1914 and 1915 only.
| Reported present in swabs examined during 1911-13 only.