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notified, 6 were subsequently found not to be suffering from the
malady.
The mortality was low, being 63 per 100 cases for London, 75 for
Westminster. Anti-toxin was supplied in 2 cases.
In 3 instances 2 cases, in one 3, and in one 4, occurred in one house.
Bacteriological Examination.—Advantage was taken by medical men
of the means provided by the City Council to have the diagnosis of
their cases assisted by bacteriological examination of swabbings from
the nose or throat in 146 cases.
In 10 instances I had a bacteriological examination made of the
throats of the members of families in which a case had occurred, or
when children were excluded from school in consequence, and no medical
man was in attendance ; the bacillus was not present in any of them.
In one instance examination was made on account of other cases
occurring subsequent to the first patient's return from hospital—it
proved negative.
Typhoid Fever.—The number of cases notified, both in London and
Westminster, show a great decrease, although in the beginning of the
year the complaint was more prevalent than usual. Of the 17 persons
notified in the City 2 were eventually declared not to be so suffering,
and 1 case was not notified, the nature of the disease not being
recognised until after death.
Of the 16 actual cases, 4 of the patients contracted the disease
out of London, most of them abroad; of the remaining 12 no definite
history was obtainable in 8 instances, 4 were ill after eating shell fish.
Five deaths occurred.
Advantage was taken to obtain the City Bacteriologist's opinion in
11 cases, in 2 the Widal reaction was"reported.
Puerpekal Fever.—Nineteen cases were notified with 6 deaths, the
average number of cases is 6. In London there were 381 cases, the
average number in the last five years having been 271. Enquiry was
made in each case. Seven cases occurred in the first quarter, 4 of which
were attended by the same medical man during two days. As soon as
the first case showed symptoms of septicaemia, he discontinued
attending confinements for a month. Three cases were connected with
miscarriages. Disinfection was carried out after each case, and included
the clothing, obstetric bags, &c., of doctors, nurses, and others in
attendance.
Ophthalmia Neonatorum.—Eighteen infants were notified as
suffering from this complaint. In 5 instances it was the first confinement.
Three of the children were illegitimate. Eleven of the homes