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year 1885. During last summer, however, this disease
showed evidence of spreading in London, a total of 29
deaths being recorded in the year.
Scarlet Fever.—Twenty.nine deaths were due to scarlet
fever—10 at their homes and 19 in the fever hospitals.
In the preceding year there were 7 deaths from this cause.
Like the rest of London this district suffered from a somewhat
considerable prevalence of scarlet fever during the
spring and autumn months. It is, of course, not possible
to say whether the epidemic was more extensive than in
previous epidemic years, because before 1890 there was no
notification of infective diseases. The mean average of deaths
for the last 7 years, however, is 15 when corrected for
increase of population, but in 1888, when the disease was
epidemic, there were 31 deaths caused by it. During last
year there were 887 cases reported to us, so that the case
mortality was 3.2 per cent. The Asylums Board were
unable to accommodate all the patients who sought
admission, and during 3 weeks—at the end of September
and in October—cases could not be removed without a
a delay of several days, and in a few instances as much as
a week. This we found to have a serious effect, in
instances where isolation could not be carried out in the
houses of the patients, in causing other cases to occur.
It is noticeable that year by year a larger proportion of
the sufferers from infectious disease are removed to
hospitals, a tendency which we welcome from the public
health point of view; but it is evident that very largely
increased accommodation will have to be provided by
the Asylums Board, if this tendency persists, as it
probably will. In this district 446 cases of scarlet fever
were removed to hospital, a proportion of 50.3 per cent,
of the total number of cases that occurred.
Diphtheria.—The deaths from this cause were 57, of
which 36 occurred at their homes and 21 in the hospitals.