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was in Southwark (0.57), and lowest in Hampstead (0.09). The whooping-cough death-rate in each of
the four quarters of the year 1904 were as follows: first quarter, 0.51; second quarter, 0.44; third,
quarter, 0.21 ; and fourth quarter, (0.13 per 1,000 persons living.
It is interesting to note that the decline in the mortality from whooping-cough, which appears
to have begun in the decennium 1871-80, and was conspicuous in the decennia 1881-90 and 1891-1900,
has been since maintained.
Medical officers of health receive information from teachers of the absence of children from schools
on account of whooping-cough, and in this way efforts are made to prohibit infectious children from
attending schools.
The number of cases which come to the knowledge of medical officers of health is thus stated in
some of the annual reports: Paddington 196, of which 89 were reported by teachers; Hammersmith 102,
Westminster 62 (56 from teachers); Islington 1,293, from teachers; Hackney 273, from teachers;
Shoreditch, 159, from teachers; Bermondsey 334 cases, and 92 contacts from teachers; Lambeth 431,
from teachers; Wandsworth 163, from teachers; Lewisham 173, from teachers, and 72 contacts.
The Medical Officer of Health of Lambeth states that disinfection was carried out in 380 cases, all the
cases being visited by women inspectors.
Typhus.

In this table where — is inserted no death occurred.
The death-rate in each year since 1868 in relation to the mean death-rate of the period 1869-1904
is shown in diagram XIII.
During the year 1904 three persons were certified to be suffering from typhus, residing respectively
in the City of Westminster, Islington, and Stepney.
The only cases of typhus known to have occurred during the year were—
1. A man, aged 40 years, admitted into the Seamen's Hospital on the 9th March from Gravesend,
where he had been working.
2. A grocer's traveller, aged 22 years. He was admitted from a house in Mile End, where he
had been living for some time, into the Eastern Hospital on the 30th April.
3. A tailor, aged 19 years, admitted into the Middlesex Hospital on the 16th May, from Old
Compton-street, Westminster. Dr. Allan expresses doubt as to this case being one
of typhus.
4. A woodcarver and hawker, a Russian by birth, aged 24 years, admitted on the 7th
September, into the Eastern Hospital from a house in Highgate-hill, where he had been
resident for ten days. Prior to that period he had been living in Cotton-street, Stepney.
Enteric Fever.
The number of cases of enteric fever notified in the Administrative County of London during
1904 (52 weeks) was 1,896, compared with 2,339 in 1903. The deaths from this disease numbered 286
in 1904, compared with 368 in 1903.

The death-rate in each year since 1868 in relation to the mean death-rate of the period 1869-1904
is shown on diagram XIV.
1 See footnote (1), page 7.
2 The Infectious Disease (Notification) Act came into force in 1889.