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46
mittee also authorised a communication being addressed to London medical officers of
health, inviting them to give to the county medical officer immediate information
of any case or suspected case of plague, and stating that Mr. James Cantlie had
been retained to examine and report on any suspected case, and an arrangement had been made
with Dr. Klein for the bacteriological examination of material from suspected cases. At a later
date questions arose as to the course which should be adopted with respect to persons whose
symptoms raised suspicion that they might be suffering from plague. It was thought desirable
that such persons should be isolated during the time required to determine, by bacteriological
methods or otherwise, whether they were suffering from this disease. After communication
with the Local Government Board, it was in the first instance arranged that the
London County Council should provide accommodation and nursing for such cases, the Metropolitan
Asylums Board providing the ambulances for their removal, and undertaking the washing
of all infected articles from the buildings in which they would be housed. Later the Metropolitan
Asylums Board expressed their willingness to provide for suspected as well as actual cases, and
after conference between members of that Board and the Public Health Committee of the Council,
it was agreed that this course should be1 adopted, the Local Government Board approving the
arrangement.
Only in one instance during the year was any London inhabitant suspected to be suffering
from plague. The patient was a carman, resident in Limehouse. He was removed to one of the
Council's shelters, and material from his inguinal glands and blood were examined by Dr. Klein
bacteriologically. He was not found to be suffering from plague.
Notifiable disease in the metropolitan boroughs during the ten years 1891-1900.
In my last annual report I published a set of tables showing for each of the notifiable
diseases in the nine years 1891-1899, the number of cases notified per 1,000 living in each of the
metropolitan boroughs, and I pointed out that these tables furnished useful material for comparing
the incidence of notifiable disease on the new areas with that obtaining in previous years before
the London Government Act, 1899, came into operation. The following table shows the average
annual case-rate per 100,000 living in the ten years, 1891-1900, for each of the notifiable diseases
in the several metropolitan boroughs as constituted by the London Government Act of 1899.
The mean populations used in the calculation of these rates have been estimated on the assumption
that the rate of increase or decrease in the population of each of the metropolitan boroughs
during the decennium 1891-1900, as shown by the recent census, has been uniformly maintained—

In this table 0 0 indicates that the deaths were too few to givs a rate of 0 05; where no deaths occurred — is inserted.