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12
smallpox.

* The majority of the rates are based on figures published in the Quarterly Reports of the Registrar-General, the others on figures
supplied by the Medical Officers of Health of the Districts. The rates—except where otherwise indicated—are per 1,000 persons of
all ages of the populations, re-estimated from the last census.
†The significance of the term " Diarrhoea " was altered at the commencement of 1911. For information on this point and the
values of the rates given consult p. 55.
§ Per 1,000 births registered, as given in the Quarterly Reports, except in the case of St. Marylebone. For that Borough the
numbers of births, exclusive of births to non-resident women in Queen Charlotte's Hospital, have been supplied by the Medical Officer
of Health.
‡ From the Annual Summary (1911) of the Registrar-General.
SMALLPOX.
During the year one case of this disease was notified in the Borough in the person of a
woman, aged 36 years, but the diagnosis was not verified at hospital.
In the whole Metropolis 72 cases were reported during the year, one being a " Port" case
(imported from abroad). Of the remaining 71 cases, 58 were reported in the course of the three
weeks ended March 11th. Only one case was reported during the third quarter of the year, and
none in the fourth.
Last year complete returns of the notification of infectious disease in the whole of England
and Wales were available for the first time. The cases of smallpox notified during the year
numbered 304,* 31 to Port Authorities, occurring among ships' crews and passengers, 202 to
the Extra-Metropolitan Sanitary Authorities, and 71 to Metropolitan.t The returns for the
four quarters of the year are given below.
Quarters, 1911 1 2 3 4
Metropolis 63 7 1 —
Extra-Metropolis 102 70 22 8
Ports 5 16 4 6
Excluding the "Port" cases, the notifications represent a morbidity rate of 0.008 per 1,000
persons.
* The totals given above have been abstracted from the Weekly Returns issued by the Local Government
Board. Since the paragraph was written a Report—"Statistics of the Incidence of Notifiable Infectious Diseases
in each Sanitary District in England and Wales during the year 1911"—has been published by the Board. The
totals for the year given in that Report are 72 cases of smallpox in London (including Port of London), and 193
in other places in England and Wales. A comparison of the totals of 193 and 233 suggested that 40 cases (17.1
per cent, of the total originally notified as smallpox) were erroneously diagnosed in the first instance.
† Of 65 cases admitted to the hospitals of the Metropolitan Asylums Board during the three weeks ended
March 11th of last year, 8 (12.3 per cent.) were definitely reported as "not smallpox" and 2 as "doubtful," from
which figures some idea can be obtained of the degree of uncertainty attaching to original diagnoses due to the
continued freedom of the country from the disease.