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79
a huge area as London, with its myriad complications
and problems, it is essential to successful administration
that there should be local organisation with a
large degree of autonomy in dealing with local needs.
With such organisation, it would be possible to provide
valuable therapeutic means which recent scientific
research have made available, thereby curtailing and
preventing much of the disease which is now endured.
The treatment of Rheumatism on modern lines is only
one illustration of this need. Hydrotherapy, radiant
heat, inhalation and light treatment, all await some
practical scheme for local health clinics.
To some extent through his Maternity and Child
Welfare Centres or through a Diphtheria Immunisation
Clinic and certainly through the work of his Sanitary
Inspectors and by Housing Schemes, the Metropolitan
Medical Officer of Health may do much in preventing
disease. With his present restrictions, however, it must
be confessed that he must largely rest content with
waging a defensive war against the few diseases he
is permitted to recognise and deal with. Among these
Smallpox has played a leading part during the past
few years. It is reported on fully later in this report.
A diagram showing the incidence of the principal
notifiable diseases during the past 30 years follows.
Diphtheria.
There were 439 cases of diphtheria notified during
the year. The age grouping of the cases is given in
the accompanying table. All the cases were removed
to an isolation hospital.
Fourteen deaths from this disease occurred during
the year, equivalent to a case mortality of 31 per
cent., or general death rate of 0.12 per 1,000 of the
population.
In view of the considerable discussion during recent
years of the incidence and mortality of Diphtheria, in
connection with proposals for the adoption of the Schick
test and immunisation by means of toxin-anti-toxin,
the following figures are given as to the experience of
the Borough: —