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of 386, 386 and 358 in all public institutions. This increase is due
partly but not entirely to the change in the character and control
of these institutions. By the Local Government Act, 1929, these
institutions were transferred from the Boards of Guardians to the
County Councils, and the old stigma of the Poor Law was removed.
But the popularity of these institutions had commenced before the
transfer, and even when they were under the control of the Guardians
the general public were making increased use of the facilities which
they offered.
During the last 30 years, as far as this district is concerned
the great voluntary hospitals of London have declined in their popularity.
With the exception of the West London Hospital, fewer
deaths have occurred in the Voluntary London Hospitals in the
last 5 years, than occurred in them 30 years ago.
Inquests and Coroner's Inquiries.
Thirty inquests were held and in 27 instances the Coroner
issued a certificate without an inquest after he had ordered a postmortem
examination.
INFECTIOUS DISEASES.
Scarlet Fever.
Two hundred and thirty-six cases of Scarlet Fever were
notified last year with one death. These figures are sufficient to
indicate that the type of the disease was mild. For a number of years
the mildness of Scarlet Fever has been a subject of comment, but
in the Annual Report of 1932, a resume of the history of Scarlet
Fever was given, and it is evident from that history that Scarlet
Fever throughout some centuries has varied greatly in its severity.
A mild type would be followed by one of extreme malignancy, and
mild and severe epidemics have alternated throughout the ages.
If the prevalent views of Scarlet Fever are accepted, the mild
type which now prevails does not mean that there is an alteration
in the character of the disease. The behaviour of Scarlet Fever
varies considerably not only in different areas but in different districts
of the same area. These variations are explicable if we are
willing to accept that Scarlet Fever is not a specific disease, but that
the Scarlet Fevers are a group of somewhat specialistic reactions
to a group of allied parasites.
It has been found that the incidence of the types of streptococci
in Scarlet Fever varies in different localities and reflects the
clinical character of the prevailing scarlatinal infections.