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45
There were two cases of "continued fever" notified.
Puerperal Fever.—Nine notifications were received and five deaths
ensued. The cases were all in the south-west part of the City. No
evidence of want of care of those in attendance was discovered. In
one case the illness was evidently due to tuberculosis.
Disinfection was carried out after each, including the clothing, &c.,
of those in attendance. In two instances there were insanitary conditions,
existing.
In London as a whole there was a slight increase in the number of
cases.
Erysipelas.—An enquiry has recently been made among Metropolitan
Medical Officers of Health with reference to erysipelas by Sir Shirley
Murphy. From the replies it appears that disinfection of rooms and
of clothing is not generally practised except in special eases.
Opinions vary as to the usefulness of notification. One medical
officer considers it is not worth the money paid for it, another considers
it essential as tending to maintain the health of the borough, and another
points out that in 26.6 per cent. of the cases various insanitary conditions
in the homes of the patients have been dealt with. Generally the conclusions
are in favour of the retention of notification. The sum payable
for the notification of erysipelas in the whole of London probably does
not exceed £500 a year.
In some boroughs, the majority of the cases are derived from
common lodging houses, shelters, and Poor Law Institutions, but
in other boroughs the number so derived was only 20 per cent. of the
total. In Westminster during the last five years only about 8 per cent.
of the cases were from common lodging houses or infirmaries, &c.,
no home address being given.
In Westminster disinfection is not carried out after every case.
Each is enquired into, and if it is found that the condition of the
premises, bedding and clothing require it, or that the erysipelas was
associated with a discharging wound, or if a confinement is expected in
the house, then disinfection is carried out. In 20 per cent. of the total
eases notified disinfection was carried out, but only in 10 per cent. of
those notified from private dwellings.
In the summary of the replies to the enquiry, except puerperal fever,
no connection with other notifiable infectious diseases appears to have
been traced ; but as the question only asked if observations were made,
there may have been other diseases such as infantile diarrhoea and other
septic infections in houses in which erysipelas has occurred, which were
not mentioned in the replies.
With the view to discover if any apparent connection existed
between erysipelas and other diseases of that class I have examined
D