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12
cases of enteric fever occurred in Brompton. A death in Bangor
Street, Notting-hill, from this cause, furnished the grounds of an
alarming report on a supposed "fever den." On enquiry it turned
out that the child had not been in the parish long enough to have
contracted the disease; and the almost sudden death—the child
having been in apparent good health a few hours before her decease
—could not be traced to any definite disease, medical opinion
merely asserting a probable in the absence of any demonstrable
cause of death. An inquest had been held in consequence
of the suddenness of the death, and the jury on viewing the body
being annoyed by a bad smell, the coroner directed my attention to
the place on the supposition that the smell indicated a sanitary
defect which might have been the cause of the child's illness.
The house which had recently been cleansed, etc., was on inspection
found in general good condition.
The deaths from diarrhœa (107) were 29 below the actual average
number in the last ten years.
Whooping cough was the most prevalent and fatal disease of the
zymotic class, the deaths, 107, exceeding the average by 41.
There is too much reason for the belief that many of the
deaths set down to whooping cough, are due to the want of medical
and other attention, the disease being thought too lightly of by the
poorer classes which furnish its principal victims, and medical
attendance being frequently dispensed with until too late to be of
any service. A district medical officer lately told me that he was
rarely called to a case of whooping cough until the child was
dying, the object of seeking assistance then being, the desire to
avoid a fuss about a certificate of the cause of death. The necessary
confinement of the little patients to one room is too often neglected,
but it must be admitted that the circumstances of the poor oppose
practical difficulties in this respect.
With reference to the important question of the treatment of
the infectious diseases, especially scarlet fever and "fever," I have
again to direct attention to the unwillingness of poor persons
to avail themselves of the accommodation provided by the
Metropolitan District Sick Asylum Board in the Hospital at Stockwell.
One of the consequences of the prejudice underlying this
objection, is the transference to private and charitable medical
practice of many cases that would otherwise be treated by the
District Medical Officers. Very few cases come under the notice
of the District Medical Officers, but the Dispensary Surgeons have
no cause to complain of want of patients. And here I may mention
that having knowledge that many of the cases under treatment
recently, in connection with the Kensington Dispensary, were
without "proper lodging or accommodation," without which they
could not be safely treated at home—some of the sick being, in
fact, members of large families in occupation of single rooms, I
called the attention of the Committee of the Dispensary to the subject,
pointing out that the valuable institution over which they
preside might easily become an agency for the spread of infectious