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Now, any educational scheme can only be regarded as complete
when it is carried with certainty and promptitude to those who more
particularly stand in need of it and are the most likely to act as
possible sources of danger to the community; and the measures must
reach the masses who occupy lodging-houses, poor class tenements
and tenemented dwellings, work-rooms, etc., are concerned. Above
all, it is necessary to know where the infected houses are, and this
information can be obtained by notification and by notification alone.
TYPHOID FEVER.
Of the 21 cases notified daring the year, all occurred in different
houses, in two of which there were grave insanitary conditions; in
two the insanitary conditions were slight, and in the remaining 17
there were no insanitary conditions. Three of the cases, doubtless,
contracted the disease outside London. The infection appeared to be
due to the consumption of oysters in two cases.
The disease frequently spreads from obscure cases in which
the nature of the disease is not recognised; and the risk of
the retention of cases of enteric fever in the houses of poor persons,
where the conditions of life are such as to give opportunity for
extension of the disease, is borne out in many recorded instances.
The early recognition of enteric fever, the use of the Widal test in all
doubtful cases, the isolation of the sufferer, and the employment of
persons beyond middle life to attend upon the sick, are all needed to
limit such spread of the disease. In several instances the consumption
of shell-fish was ascribed as the cause of the disease; but in the large
majority of cases the origin of the infection remained obscure.
DIPHTHERIA.
The 120 cases of Diphtheria occurred in 103 different houses;
and in only three instances were sanitary defects of a grave nature
found to exist in the home of the patient. Slight sanitary defects were
found in 13 other cases.