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from it than from Small Pox, Scarlet Fever, Diphtheria, Croup, and Enteric Fever
put together. The number of hospitals required, calculated on this basis, would be
enormous. Would the results that one might reasonably expect justify the means 1
The majority of the Medical Officers of Health of the districts where compulsory
notification has been tried approve of it, but scarcely any can point to a diminished
prevalence of the disease. I maintain, however, that any steps that are taken
without compulsory notification are of no use. By notification you certainly receive
information where the first cases occur. The inspection and, if possible, isolation,
with full instructions and periodic visits to see that these are carried out, would
be of some use, if only to warn the parents against pulmonary complications which
are so frequently fatal. Sufficient care is not exercised by the parents to prevent
these serious complications. These visits would also tend to prevent the spread of
the disease, as well as lead to the increased appreciation by the public of the serious
nature of the disease.
As I am afraid compulsory notification with removal to isolation hospitals
would not be justified by the results, the attempt to strictly carry out the
other measures mentioned will be treated with ridicule, and tend to bring
preventive measures generally into disrepute.
Scarlet Fever.
816 cases of Scarlet Fever were notified, of which 719 were removed to the
various Fever Hospitals.
156 occurred in the Limehouse District, with 1 death.
144 occurred in the St. George's District, with 3 deaths.
278 occurred in the Mile End District, with 6 deaths.
238 occurred in the Whitechapel District, with 8 deaths.
The number of notifications is 138 and the number of deaths 8 less than in
the preceding year. This reduction has occurred in three out of the four districts,
the number of cases being 35 less in the Limehouse District, 30 more in St. George's,
121 less in Mile End, and 12 less in the Whitechapel District.
The death-rate for the whole of the Borough was at the rate of .06 per 1,000 of
the population, that for the whole of London being .08 per 1,000.