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the number in any other month did not exceed 3 until in the four
weeks ending November 5 when the deaths rose to 8; the
deaths in the following four weeks were 8 likewise, and in the
last four weeks of the year they were 22. Such was the commencement,
as indicated by deaths registered, of the epidemic
which is still raging, and which has proved more fatal than any
that has visited the Metropolis for many years. The Registrar
General states in his annual summary, that the death rate from
whooping cough in 1881 was the lowest on record, only 1,961 deaths
having been attributed to it, whereas there would have been 3,144,
had the mortality been at the average rate of the preceding ten years.
Scarlet Fever was much less prevalent and less fatal than in
1880, in which year 105 deaths were recorded. Of the 38 deaths
in 1881—28 belonged to the Town registration sub-district and
10 to Brompton: 8 occurred in the hospitals. Two hundred and
eighty-seven cases of the disease were recorded, of which 146
occurred in the northern half of the parish and 141 in the southern
half, taking Uxbridge Road as the dividing line. There was
no very marked prevalence of the malady at any one period of the
year, the cases recorded in my 13 reports, each covering a period
of four weeks, being 24, 31, 18, 27, 18, 15, 17, 17, 18, 32, 23, 29,
and 18: 110 cases were removed to hospital. In respect of
the remaining 177 home treated cases it may be observed of
some few that they were well isolated and otherwise well provided
for and did not need removal, but a large proportion of the cases
which should have been removed were concealed. In not a
few instances removal was resisted and in the present state
of the law could not be enforced. The disease did not prevail
epidemically and therefore did not spread to the same extent as
in the previous years. It need hardly be said perhaps that
a great majority of the cases were of children, usually of school-age,
and in fact about one hundred of the children had been attending
school up to the time of the attack. Every effort was made by
co-operation with school teachers, visitors, &c., to prevent the
disease from spreading especially by keeping from school all children
living in houses where it existed.
The existence of the disease was in many instances revealed on
the registration of a death, and it may be truly said that the spread