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scarlet fever. 9
negative while the 196 positive results were obtained from swabs taken from throat in 195
instances, from the nose in 32, from the nose and throat in 3, from the ear in 11, and from the
eye in 1. Nose, eye and ear cases are almost invariably cases of "bacteriological diphtheria."
Of the 120 patients sent to the Board's Hospitals after bacteriological test—in which group
the average duration of stay was 51*7 days—35 were in hospital for less than 28 days, i.e. 29
per cent, of these patients were kept for less than half the average term for all patients of this
category. The average stay for patients sent in without previous test was 60'9 days, and the
number of such patients detained for less than half that period (4-5 weeks) was 34, or only
17*1 per cent. As a rough approximation it is probable that some 30 per cent, of the cases
sent to the Board's Hospitals during the past year were cases of "bacteriological diphtheria."
In 1918 when an analysis of these cases was prepared by the Board 17*7 per cent, of the cases
admitted from the Borough were cases of "bacteriological diphtheria." Since that year the
practice of swabbing has extended and hence it is more than probable that the proportion of
these cases has increased.
In addition to the cases of "bacteriological diphtheria" which were included among the
318 cases analysed, there were at least 39 other cases among the 127 cases excluded from the
analysis. Of the 47 cases reported among the "residents" in the Infirmary there were in all
25 cases of "bacteriological diphtheria," of which 11 were not sent to the Board's Hospitals.
Three of the patients were reported twice within the year and one three times. Among the
18 cases reported from St. Mary's Hospital there were 15 instances of patients being kept
at that Hospital. Seven other instances were recognised among patients kept at home, and a
like number among the cases reported by the Asylums Board as "errors." These figures,
which do not, it is thought, err on the side of excess, show a proportion of 30*7 per cent., thus
in a way confirming the estimate, or guess, given above for the cases sent to the Board's
Hospitals.
Carrier Clinic.—In 1920 a Special Clinic was opened at St, Mary's Hospital for the
treatment of "carrier" cases of diphtheria. In that year 8 patients (if the persons, mostly
children, can be rightly so described) were referred to the clinic, and last year, 21. The 29
cases were almost equally divided between the two sexes, 15 males and 14 females. Of the
29 patients, 4 ceased attendance before they were "cleared," i.e., that three successive swabs
had been taken and found to be "negative." The average length of "treatment" for the
remaining 25 "patients" was 22'5 weeks. Three patients (children) attended for 98, 98 and
100 weeks each. If those cases be excluded, the average for the remaining 26 cases was
12 weeks with a minimum of 2 weeks.
Scarlet Fever.
General Prevalence.—Last year's total of 827 cases was the maximum for any year since
compulsory notification was established by the Notification of Diseases Act, 1889. It will
be seen from Table V., that this disease has steadily increased in prevalence since 1917,
when 124 cases were reported—the minimum for any year since 1890.
During the thirty years, 1890-1919, the annual average of notified cases has been 418,
the year's total lying between 500-600 and 700-800 four times (each) and 600-700 (twice).
Below are shown the years just referred to, with the numbers of deaths due to this
disease.

"C"—cases; "D"—deaths.
Note.—The one death from scarlet fever included in Table IX. occurred to a Paddington resident, the
deceased being an inmate of an outlying institution.
The epidemic of 1887—when notification was not in force—is generally regarded as an
outstanding one. The late Medical Officer of Health estimated that 568 cases occurred
in Paddington (Old Parish) during that year—about two-thirds of the total for last year. The