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72
THE CONTROL OF DISEASE.
During the year, the number of cases of practically
every infectious disease showed a substantial decrease,
except Pulmonary Tuberculosis and Ophthalmia Neonatorum.
Scarlet Fever dropped from 786 to 435 and
Diphtheria from 488 to 370. The total number of
cases of all diseases (including Tuberculosis) fell from
1,813 to 1,236.
The reasons for this welcome reduction of infectious
disease are as mysterious as those for the
substantial increase I had to record in the previous
year. Malnutrition has been cited as a probable
explanation, but while this is a factor which cannot
be ignored it does not seem very reasonable to suppose
that the standard of nutrition in the borough suddenly
fell in 1933 sufficiently to explain the heavy incidence
of infectious disease and its virulent character in that
year or that it rose again in 1934 to such an extent
as to cause a 50% fall in the amount of such disease.
It is rather more scientific to attribute a good many
of these fluctuations to the periodic character of the
diseases in question, which may of course be complicated
by variations in the physical condition of the
population, virulence of the infection, housing, etc.
In any case it is difficult to draw precise conclusions
from the statistics of infectious disease for a single
London borough or even for the County as a whole
because of the inter-communication which takes place
between home and workplace, restaurants, places of
amusement, buses, trams, trains, etc. over a large
area in London and Greater London. Nevertheless,
as there is a reason for everything if it can only be
found, it is desirable that research should be conducted
into the causes for these variations, with a view if
possible to determining the relative influence of such
factors as malnutrition, housing, smoke, sunlight, as
well as the special characteristics of the diseases
concerned.
The accompanying table shows the number of
cases of each disease, the age composition of the
patients and the numbers removed to hospital.