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it is an obvious inference, moreover, from the sad history that if the
groom had been informed of the nature of his illness at the
"dispensary " he might have gone direct to hospital, and all the
misery resulting from his reception at the house in Clareville
Grove might have been avoided: possibly if he could have
been removed from the house on the 25th July no ill effects might
have followed, the first case in the landlady's family not having
occurred till some eleven days subsequent to that date. When
the house was visited August 23rd, the second child was lying
dead, and the other patients were too ill to be removed. All the
cases were under the care of the doctors at the dispensary at which
the groom had called on July 25th.
Scarlet fever is a disease not always easy to recognize, and nonrecognition
of the real nature of obscure cases has led to the
extension of the disease. Thus in one case of a child whose
death was registered as "acute sewer-gas poisoning; cardiac
failure," the subsequent illness of the father proved the child's
illness to have been scarlet fever; and in another case at no great
distance, in point of locality and time, a somewhat obscure illness
which proved fatal, the cause of death being registered as " enteritis,
perforation of the bowels," was proved to have been scarlet fever
by the subsequent occurrence of other cases in the family.
Diphtheria.—The deaths from Diphtheria were 16, eight in
each sub-district, the corrected decennial average being 20. One of
the deaths was of a gentleman aged 76, a very unusual age: another
death was of a child, the nature of whose illness appears not to
have been suspected until fatal paralysis supervened; this case was
imported. In one family there were three cases, one fatal: in no
other family to my knowledge, did the disease spread beyond the
person first attacked, and it may be said that the facts that came
out on enquiry in some instances, at least, suggested the possibility
that a non-specific, i.e. non-infectious throat complaint, may have
been mistaken, by reason of its severity, for the disease in question.
Diphtheria as it is observed in the country, appears to have a greater
disposition to spread than in London where however, last year,
654 deaths were attributable to it, a number considerably above the
decennial average. The disease in Kensington has never appeared