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In London, as a whole, the deaths from this cause were 756, and 116 above the corrected
average. The cases admitted to hospitals were 1,728, the deaths in hospitals 245, a case-mortality
of 14.1 per cent. The notified cases were 4,309 in number.
In the autumn cases of enteric fever are not infrequently imported from the country, and
from seaside and other holiday "health resorts." Several instances of this sort occurred in the
borough. The infective material of enteric fever is not infrequently conveyed by shell-fish,
derived from specifically contaminated water; and it is worthy of remark that in several of the
cases locally recorded, the sufferers had partaken of oysters, mussels, etc., at seaside and other
places within such periods of time antecedent to date of illness, as to suggest a relationship of
cause and effect.
There was no death in the borough from typhus fever or simple continued fever. The
deaths from these causes in London were 2 and 7 respectivelys the notifications 7 and 73. In
Kensington no case of typhus was notified: the notifications of simple continued fever were ten.
DIARRHOEA.
Diarrhoea was the cause of 105 deaths, against 125, 112, and 101 in the three preceding
years ; 98 in the Town sub-district, and 7 in Brompton, the corrected average being 94. Eightynine
of the deaths took place in the sixteen weeks ending November 3rd; 30, 30, 10, and 10
in the four successive four-weekly periods. These deaths were irrespective of the deaths from
gastro-enteritis, which are now separately classified by the Registrar-General. The deaths
from this cause were 21—17 of them under five years of age, including 16 in the first year of
life. Ninety-two of the deaths from diarrhoea were of children under five years, including 80
under one year. The deaths from diarrhoea in London, as a whole, were 3,564, and 162 above
the corrected decennial average.
Considerable attention was given during the year to the classification of deaths commonly
and somewhat indiscriminately attributed to diarrhoea. At the instance of the Society
of Medical Officers of Health the matter received the attention of the Royal College of
Physicians, with the result that the Registrar-General issued a fresh instruction* for the
guidance of sub-district registrars when registering the causes of death, especially during
the hot season of the year. A number of "causes" of death loosely used in the past were
eliminated, and deaths from the said "causes" were directed to be registered as epidemic
enteritis, or zymotic enteritis, or epidemic diarrhoea.
INFLUENZA.
Eighty-five deaths were registered from influenza, against 44, 70, and 103 in the three
preceding years. Sixty of the deaths occurred in the Town sub-district, and 25 in Brompton.
The deaths in London, as a whole, from this cause were 1,950 (as compared with 491, 679, and
1,817 in the three preceding years), this being the highest number recorded since 1895.
OTHER DISEASES OF THE ZYMOTIC CLASS (CLASS I.).
Order 5 (Venereal Diseases) includes Syphilis, Gonorrhoea, and Stricture of the Urethra.
Syphilis was the registered cause of 19 deaths, against 21, 16, and 17 in the three preceding years
respectively. Sixteen of the deaths occurred in the Town sub-district, and 16 of them were of
children under one year of age. If the truth were known, it would probably appear that this
Protean malady was accountable, directly or indirectly, for many deaths in excess of the record.
There was one death from Stricture of the Urethra.
Order 6 (Septic Diseases) comprises Erysipelas, Pyœmia, Septiœmia, and Puerperal Fever :
the total deaths registered were 14, as compared with 21, 12, and 17 in the three preceding years
respectively. Erysipelas was the cause of 9 deaths,† six of them in the Town sub-district, as
compared with 9, 7, and 8 in the three preceding years. There was no death from Pyœmia or
Septicaemia.
Puerperal Fever was the registered cause of 5 deaths, of women between 15 and 45 years of
age (as compared with 5, 5, and 5 in the three preceding years respectively), all of them in the
Town sub-district. In addition to these 5 deaths, other 19 deaths (all but 3 of them in the Town
sub-district) were registered as having occurred in childbed; as compared with 9, 6, and 4, in the
three preceding years respectively. The deaths registered as having been caused by diseases and
* The instruction was to the following effect :—
" Diarrhœa.— This should be registered as the cause of death, only when diarrhoea is written alone, or when
it is coupled with some ill-defined cause, such as atrophy, debility, marasmus, thrush, convulsions, teething, old
age, or senile decay. In addition to deaths ascribed to diarrhoea, deaths from intestinal or enteric catarrh, from
gastro-intestinal or gastro-enteric catarrh, or from epidemic enteritis or zymotic enteritis must be included
under this heading ; but deaths from gastric catarrh, gastro-enteritis, or enteritis must be excluded from this
heading."
† The notifications of erysipelas were 159, many of the cases being of traumatic origin, unimportant in character,
and such as the framers of the Act could scarcely have intended to be notified.