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69
past few months, but there must be some local cause
to account for its special incidence on this part of
Clapham. Local obstruction of several house-drains
seems in a few cases to have been the exciting cause:
and it is highly probable that direct infection accounts
for others.
Scarlet Fever was the cause of 6 deaths in the subdistrict,
and 2 in out-lying institutions. This is equal to
a, death-rate of 0.18 per 1,000 of the estimated population,
as compared with 0.34 per 1,000 for the whole of London,
and 0.43 in the 27 chief provincial towns. 55 cases of
Scarlet Fewer were admitted from Clapham into the
Asylums' Board Hospitals, as compared with 22 in the
previous year. The Scarlet Fever epidemic which has
prevailed throughout London during the latter half of
the past year has been of a peculiarly mild type. The
death-rate for the whole Metropolis from Scarlet Fever,
although showing a considerable increase on the corresponding
rates for 1885 and 1886, was lower than in any
previous year of which record exists, and was very little
more than half the mean annual rate during the years
1871-80, which again was little more than half the mean
rate in 1861-70. It will be seen also that although there
has been a considerable amount of Scarlet Fever in Clapham,
its death-rate from that disease was only half that
of the whole Metropolis from the same disease. The continued
spread of this disease is due to two causes which
are in some measure complementary; the carelessness
and apathy of poorer people in regard to the spread of
infection: and the lack of compulsory notification of infectious
diseases, which prevents the sanitary officials
dealing with an epidemic in its earliest stages, thus
obliging them to stand in the position of the man who
closes the stable-door after the horse is stolen.