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36
The death.rate from this disease in each year since 1868 in relation to the mean death-rate
of the period 1869-98 is shown in diagram XVI.
Diagram XVIII. shows the seasonal notification curve of enteric fever for the period 1890-98
and the year 1898. It will be observed that in 1898 the autumnal rise begins later and ends later than
in the period 1890-98. I do not propose at the present time to discuss this subject further, but
may state that the variations in the behaviour of enteric fever in different years is still engaging
my attention.
In the distribution of enteric fever mortality during the year, the northern and eastern
groups were above, and the western, central, and southern groups below the average of London.
Of the several districts Greenwich had the highest death-rate (0'21), and Rotherhithe the lowest
(0'02). During the first quarter of the year the central group of districts had the highest, and the
western the lowest rate of mortality; during the second quarter the eastern group had the highest,
and the northern and central the lowest rate of mortality; during the third quarter the northern
and eastern groups had the highest death-rate, and the western and central groups the lowest.
During the fourth quarter the northern group of districts had the highest death-rate, and the
central and southern groups the lowest. The mortality-rate in this quarter in each of the groups
was, however, considerably in excess of the average for the year.

The reports of the medical officers of health contain the following references to enteric
fever in their districts—
Paddington—The medical officer of health gives an analysis of the cases of enteric fever
in 1898 in his district. He found that in South Paddington it was so distributed that each case
occurred in a different house, whereas in North Paddington two cases occurred in each of two
1 See footnote ('), page 8.