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last year nine cases of suicide occurred, compared with eight the
previous year.
I have pointed out in previous reports the attitude of the
public towards the treatment of disease in Institutions, and the increasing
number of deaths in Public Institutions. Last year 363
deaths occurred in Public Institutions compared with 358 in 1934.
Inquests and Coroner's Inquiries.
38 inquests were held last year, and in 28 instances the Coroner
issued a certificate without an inquest after he had ordered a postmortem
examination. The list of inquests together with the causes
of death is given on a later page.
INFECTIOUS DISEASES.
Scarlet Fever.
103 cases of Scarlet Fever were notified, but there was no
death from the disease. These figures indicate that on the whole
the disease was of a mild character, but Scarlet Fever, under present
conditions, is one of the diseases concerning which it is impossible
to generalise. We might say of last year's cases that they
were characterised by the absence of the very severe toxic type,
but every grade of case from the very mild to the severe was met
with. This variety of type is important not only from the clinical,
but also from the epidemiological point of view. Sydenham named
the disease from the appearance of the rash, and from his time the
presence of the punctate rash of the skin has been regarded as an
essential element of the clinical picture, but there are reasons for
thinking that the same strain of the haemolytic streptococcus may
in one person cause the train of symptoms (including a rash) which
we associate with Scarlet Fever, while in another person, one or
other symptom (including a rash) may be absent, and yet the latter
may be the source of an infection which will exhibit a rash in the
infected individual. Scarlet Fever is essentially an infective nasopharyngitis,
and the symptoms will depend not only on the infecting
organisms, but also on the reaction of the individual to the infection.
This is probably one of the reasons of the failure of isolation
hospitals to stamp out the disease or even to control epidemics.
The hospitalisation of large numbers (here the vast majority) of
patients suffering from so-called Scarlet Fever, has quite failed to