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the strand district, london.
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having been exposed thereto. In 67 instances he found the
diphtheria bacillus present, in 9 the result was doubtful, and in
92 the organism was not found. Since I advocated the establishment
of laboratories whereby bacteriology could be utilised as
an aid to diagnosis (Ann. Report, 1893), many authorities in London
and the provinces have adopted the method in connection with
diphtheria, typhoid fever and tuberculosis, and the London County
Council are considering the establishment of such a laboratory for
London. As a result of the experience gained in this District,
your Board on being asked by the Council for an opinion on the
subject, replied that they were in favour of a central laboratory,
but they considered it should be supplemented by district laboratories
(not necessarily corresponding with existing local sanitary
areas), so that no time should be lost in transmitting material for
examination and in obtaining a report.
Enteric .Fever. —Nine cases of this disease were notified during
1898, as against 17 in the preceding year. Of these one gave an
address in this district, but had not resided there and no other
definite address could be obtained, two were of persons who had
just returned from the country; in two instances the disease is
believed to have been acquired through eating shellfish; of the
remaining cases one was a hospital attendant and doubtless took
the infection from another case, two worked in other parishes, one
at a ragstore and the other as a scavenger, and in one case no
source of infection could be discovered, except that the drainage of
the house was very defective. Three of the cases proved fatal,
one being the first mentioned above. The cases in London were
fewer in number than in any year since 1892.
Smallpox and Vaccination.—No cases of smallpox occurred in
this District in 1898. During that year Parliament passed an
Act enabling persons having "conscientious objections" to claim
exemption from vaccination for their children. Up to that period
about 20 per cent, of the surviving children throughout the
country were escaping vaccination; since this Act came into
force there has been a rush in a few districts to obtain exemption
certificates, but that seems to have subsided, and the general
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