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83
The numbers in the years 1887.88.69.90 and '91
(including those in outlying institutions) were respectively
21, 66, 42, 20, and 30. There has been an increase therefore
in the number on those of the last 3 years, but there are
fewer deaths than in 1888. The rise in the number of
deaths from this cause was common to the whole of London
last year, there being 712 more than the corrected
decennial average. This is associated, it must be
remembered, with steady and great improvement in
sanitary conditions generally, so that we are almost driven
to the conclusion that the spread of it is principally due
to direct infection. It is certainly the case that at present
it is not popularly regarded as being in at all the same
category, as regards infectiveness, with scarlet fever, and
probably isolation is not insisted on sufficiently long in
many instances. We are often requested to disinfect
houses a few days after the case has been notified, but it
by no means follows that infectiousness has ceased the
moment the throat has apparently cleared up. The
number of cases reported was 242, and the mortality was
23 5 per cent., so that nearly 1 died out of every 4 cases.
The removals to hospital were 88, or 36.3 per cent, of the
whole. The mortality of the hospital cases was 23.8, and of
those that remained at home 23.3 per cent. If we assume,
as is certainly the case, that the cases removed to hospital
were more severe on the average, this result is interesting
as showing that removal to hospital on the whole increases
the chances of recovery.
Membranous Croup.—There were 17 eases notified and
9 deaths. These were most probably diphtheria, and the
mortality was extremely high.
Enteric or Typhoid Fever.—The deaths numbered 12, as
against 10 last year and 17 in the year before. The
number of cases was 80, and the mortality 13.9 per cent.
That the number of these deaths tends to diminish is very