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52
the population of Westminster is much below that for London,
consequently the proportionate number of cases should also be less.
As has been reported in previous years young soldiers in
barracks have contributed a considerable number of cases.
The type of disease has continued to be extremely mild, only
nine deaths have occurred, giving a case-mortality of 1*8 per cent.,
whereas the London rate was 3*1 per 100 cases; 421 or 88*8 per
cent, of the cases were removed to hospital. During periods when
scarlet fever is of this mild variety, there are many cases not
recognised as such, there being often no rash, and only a little sore
throat and feverishness. Such cases are, of course, a means of
spreading the disease^ and counteract the good done by removal to
hospital.
The course of the disease during the year is shown week by
week on the accompanying chart (p. 48). The curves are similar to
those of previous years, except that after the usual fall in numbers
during the school holiday period, the succeeding rise was small and
did not continue.
Proceedings were taken against a man for knowingly allowing
his children to be exposed in the streets while suffering from scarlet
fever, whereby several other children were affected, and a penalty
was inflicted.
Diphtheria.—253 cases of diphtheria and membranous croup were
notified in 1901, equal to 13*6 per 10,000 inhabitants, as compared
with 26*7 for all London, which was slightly below the average.
Diphtheria, like scarlet fever, affects principally the younger
members of the population, but it is not confined to them to such an
extent as scarlet fever is. Generally about 60 per cent, of the cases
occur between the ages of three and 13, the period of school
attendance; and that was the proportion in Westminster during
1901.
There were 21 deaths, equal to a mortality of 8*3 per 100 cases,
as compared with 10*9 for London. Since the introduction of antitoxin
in the treatment of this disease the case-mortality has fallen
year by year from 23 per cent, to L0*9 per cent., which is the
lowest yet reached. By the aid of bacteriology, cases may now be
diagnosed at an earlier period than was formerly the case, and thus
appropriate treatment may be employed sooner.
Arrangements were in existence in certain of the districts on the
formation of the City, to enable medical men to have an examination
made of swabbings from persons' throats, concerning which they
were in doubt. The Council during the year resolved to extend
this benefit to the whole City, and accordingly arrangements were