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the certificate to have contributed to the fatal termination. As this
latter is a notifiable disease whilst the former is not, I have preferred
to classify the deaths under the heading of Diphtheria.
The mortality from measles was in the proportion of 5 6 per
thousand on the estimated population of young children. This
disease, the most fatal amongst the Zymotics, is constantly with us
and the mortality does not vary very greatly from year to year. A
proposal to include measles amongst the diseases notifiable under
sec. 55 of the Public Health (London) Act, 1891, was laid before the
Vestry, and was negatived on the report of the Sanitary Committee,
Measles is most difficult to isolate as it is intensely infectious from
the first onset of the catarrhal symtoms, and the mischief of communicating
the disease to other children is done before any precautions
can be taken. There is no hospital for the isolation of measles, and
if there were, I very much doubt whether parents would permit the
removal of their children to it. Under these circumstances I do
not consider that notification, under the present law, would be
worth the expense. The disease is fatal in about five per cent, of the
persons attacked, and its inclusion in Sec. 55 would mean an addition
of at least 2,000 half-crowns yearly to the notification account
of Bethnal Green. But I do think that a modified form of notification
would be useful, and not very expensive ; I would limit medical
certification to the first case in each household, and enforce the
report of subsequent cases on the parent or guardian. If we knew
of the first case in each house or family, we could notify the Schools
so that all children from such houses could be excluded, and the
premises kept under observation..
DIARRHCEAL DISEASES.
(Deaths 151. Decennial average 967.)
Diarrhoea was the cause of 148 deaths, all except eighteen of
which were amongst young children. In addition three deaths were
registered as " Choleraic Diarrhœa " or English Cholera, and one,
which was also notified as true Cholera. This was the case of a
female rag-sorter, aged 17, who died cyanosed after a few hours