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27
tious Fever Hospitals. The difficulty of dealing with
the disease has been greatly increased by the want of
some system of compulsory notification, as many cases
are not heard of till they become the cause of infection
of a number of other persons.
Measles and Whooping Cough were the cause of 42 deaths.
This is less than in the previous year, but during the
latter part of 1888 there was a considerable outbreak of
Measles, during which most of the deaths occured. These
were as usual, mostly due to chest affections, produced
by exposure to the cold, when but just convalescent, and
probably nearly all these deaths could have been prevented
by ordinary care and precaution.
Diphtheria—There were 16 deaths in Clapham and 7 in
out-lying institutions from this cause. Altogether 48
cases have come to our knowledge during the year.
This shows that, in common with London as a whole,
there has been a considerable increase in the number of
cases. This, of late, has been more marked year by year
and the reason is not at all easy of explanation. This is a
disease that is undoubtedly frequently caused by defective
sanitary condition of dwelling houses, and in about
half the total cases some defect has been discovered and
remedied. It is also frequently spread by direct infection.
and with regard to this, it is very satisfactory that
the hospitals of the Metropolitan Asylums Board are now
open for the reception of these cases, so that we may
hope that, by prompt removal and isolation, the spread of
this grave disease may be checked. Here again however
the want of compulsory notification is severely felt. The
cases have not been confined to one portion of the parish
in particular, but have been more or less distributed over
the district. Schools both public and private have been
instrumental in spreading the disease, and I believe that.