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the necessity of a separate bed, and a separate sleeping room
was difficult to obtain.
The voluntary notification of phthisis has not been
acted upon to any extent in the district, the number of
notifications received representing only a fractional number of
the cases which must exist. Although Lewisham showed the
lowest death rate of the Metropolitan Boroughs except Hampstead,
judging from the numbar of daaths reoried a large
number of actual cases must exist. The number of deaths
registered was 138, and the majority of these homes were
visited by your women sanitary inspectors, who reported that
in 46 homes where phthisis occurred other members of the
same family had previously succumbed to the disease. In eight
cases association with consumptive patients outside the family
was stated to be the probable source of infection. In no,
instance was there evidence of overcrowding,
It was impossible in all cases to obtain the consent for
disinfection after death occurred; permission was given in
respect of 54 homes only.
CEREBROSPINAL FEVER.
In accordance with the provisions of section 56 of the
Public Health (London) Act, 1891, cerebrospinal fever was
added to the list of compulsory notifiable diseases, for a period
of six months, by an order of the London County Council,
dated March 4th, 1907.
Some scare was occasioned in London about this time
and many cases were reported which subsequently proved to
be some disease other than cerebrospinal fever.
In Lewisham, three suspected cases arose, and I was
invited by the medical practitioners to see Cases 1 and 2.