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23
will therefore be taken up, Scarlet Fever cases might be nursed at
home. Measles comes in epidemics every two years, so that it may
be argued that some Scarlet Fever cases could remain at home during
periods of epidemic prevalence of Measles. I do not care for this
view, especially as regards a borough in which there are so many
houses in which two or more families are living. This subject is
undergoing consideration in one quarter; no doubt there will be
something further to be said on the subject next year.
There were 18 'return' cases during the year. In no case was
milk found to be responsible for the disease, infection being from
person to person.
Diphtheria.
The total number of patients certified to be suffering from Diphtheria
was 582 as compared with a total of 610 for the previous year. Of
this number 19 were errors of diagnosis, and 24 were cases amongst
the Staff of the South-Eastern Hospital.

I have chosen this disease amongst the first for my general observations
on infectious disease, partly because it is the principal killing
infectious disease of child life and partly because it can now be
prevented more easily than any other infectious disease. It may be
argued that more lives are lost during an epidemic of Measles, but
then Measles only comes in epidemics every two years, whereas
Diphtheria is endemic or always present in the County of London.
Amongst the European capitals London comes next to Edinburgh
and Rome in respect to fatality rate from Diphtheria.
Measles sweeps over a district or through a family, and the worst is
soon known. Diphtheria quietly plods on and adds up its toll; let
Diphtheria once get into a house where there are several children