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typhus fever; no reference to this disease, moreover, having been made
by the practitioner during the continuance of the illness.
Enteric Fever.—Twenty-four deaths were registered from this
disease, of which 10 occurred in Brompton, a large and unusual
mortality for that sub-district. I dealt fully witn the subject of
enteric fever in my last annual report (page 11), in connection
with a sharp endemic, which, commencing in November, 1877, was
prolonged until the end of January, 1878, and caused eight deaths at
home or in hospital. The localities at which fatal cases occurred
are shown in Table 9 (Appendix). I am not able to throw much
light on these cases, qua causation. A few, however, certainly six,
were imported, and in one or two others there appeared reason
to doubt the validity of the diagnosis; as, to quote but one example,
in the case of a lady whose death was attributed to "disease of
the valves of heart, three years; typhoid fever, 56 days; acute
pulmonary phthisis, 40 days," the case probably being an instance of
that sharp febrile disturbance, associated with acute tuberculosis, which
is occasionally mistaken for specific fever.
Simple Continued Fever.—The deaths from this disease were
four in number, of which one occurred in the Brompton sub-district.
SMALL-POX.
Small-Pox, which began to be epidemic at the close of 1876 is
still, at the middle of 1879, more or less prevalent in the Metropolis
generally, and in some parts of the parish; our efforts to cope with the
disease and to stamp it out not having had the success they deserved,
seeing how much time and labour has been consumed in the endeavour.
This is not to be wondered at, however, the migration of families in
which the disease makes its appearance, and the concealment of cases,
amply accounting for its spread in the parish, and from one parish to
another. The force of the epidemic has been very unequal, and sometimes
we have been deluded with the hope that it was about to cease, a
hope again and again dashed by the occurence of fresh and unlooked-for
outbreaks. The fluctuations of the disease, and the relative prevalence
of it in the parts of the parish north and south of the Uxbridge Road;