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and 1893, it was expected that, if it was introduced (an always
probable event, owing to our geographical position), it would
readily spread, especially in the most densely populated
parts.
Of the nine parishes in the district, the disease showed
itself more or less in eight, and in all 240 cases occurred in
156 private houses, while 22 occurred in institutions. This
number means that about .8 per cent, of the population were
attacked, the proportion varying from 1 per cent, in Coulsdon
to 1.6 in Mitcham.
In the parish of Mitcham, the population of which is
over 12,000, there occurred 190 cases in 128 houses. The
disease first showed itself in two houses early in January, but
nothing of importance occurred until March, during which
month seven houses in different parts of the parish were
invaded, after which a rapid spread took place, and the
prevalence became nearly general. The number of cases
increased in April, and the disease assumed epidemic proportions
during May and the beginning of June, but after this
there was a rapid decline. During August and September
the disease subsided almost completely, but October witnessed
a fresh increase, which was maintained until the end of the
year. The course of events is shown month by month in the
table on page 18.
The recrudescence which took place in the autumn and
winter months may be attributed to the tendency which scarlet
fever possesses in this country of becoming more prevalent
at that season, but the epidemic of May and June was at
its height at a time when, as a rule, the disease shows a
minimum prevalence, and was obviously due to the special
cause at work, namely, its comparative absence, especially
from this parish, during the preceding five years. Other
important factors in the rapid spread which took place were
the overcrowding of the population which now exists in parts