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8
facilities for isolating such cases in hospital. The writer fails
to see the logic of taking precautions against the less fatal and
allowing the more fatal malady to run its course.
Even although it must be allowed that the spread of infection
may not be materially influenced by early isolation of cases
of measles, yet without doubt the removal of children when ill
of so serious an infantile disorder from unsuitable surroundings
and placing the patients in institutions where they would obtain
skilled nursing with the requisite medical attention, would reduce
the mortality.
DIPHTHERIA.
Diphtheria was generally above the average until December,
when it declined. There were three decided rises above the
mean (see curve), viz., in the third week of May, the last week
of July, and the second week of November.
The number of cases notified amounted to 199; of these
36 died, giving a case mortality of about 18 per cent.—a deathrate
per million living, of 254.
During the year 43 specimens from suspected diphtheritic
throats were examined bacteriologically at the Jenner Institute,
and 22, or about 51 per cent., were pronounced to contain the
true diphtheria bacillus.
ENTERIC OR TYPHOID FEVER.
Typhoid was under the average until December, when the
cases rose to their maximum. The maximum number of cases
usually occurs in the autumn. Indeed, one of the old names
for typhoid is "autumnal fever." Hence so far as this district
is concerned, there is a displacement in the period of maximum.
The Medical Officer of Health for St. George's has noticed
the same thing, and since typhoid is a water-borne disease,
suggests, with some confidence, that the abnormal rise is caused
by impurities in the water-supply derived from the Thames.
The winter rains surcharge the river with filth, the filters get
overtaxed, imperfectly filtered water is drunk, some of which
contains the specific germs. This suggestion is ingenious, and
may be true, since the winter service of water is slightly more
impure than the summer. There is, however, another explanation
of a similar character. As it is well known and acknowledged
that during the heavy winter rains, estuaries, rivers, and