View report page

21
arrangements of many of the houses; and this leads me to
remark that overcrowding and insanitary conditions generally,
which alone may produce disease,e.g., pneumonia—to quote but
one illustration—will naturally tend to aggravate any and every
disease, and may easily turn the scale against a patient who, in
more favourable circumstances, would have had a good chance
of recovery. Whooping cough had been prevalent in the
locality for a considerable time prior to the first death. Under
a system of "Notification of infectious diseases," the existence
of the epidemic would have been revealed at a much earlier
date.
Scarlet fever was the cause of 62 deaths, or five above the
corrected decennial average; in the two preceding years the
deaths were 105 and 38 respectively. Of the 62 deaths 49
belong to the Town Sub-district, including 11 that took place in
Hospital, and 13 to Brompton. Three hundred and nineteen
cases were recorded, viz., 217 in the district north of Uxbridge
Road, and 102 in the remainder of parish south of that road.
Considerably less than half of the known cases were removed to
hospital; many cases were concealed; and frequently when the
existence of the disease became known at an early period, it
was found impossible to persuade parents to consent to the
removal of their children. In many instances, when it was too
late, the refusal came to be lamented. Some patients, of course,
were well isolated at home, and removal was unnecessary, but
there were not wanting proofs that, even when the patients had
"proper lodging and accommodation," either due care was not
taken to prevent the spread of disease, or that no amount of care
suffices, in some cases, to prevent its spread. In not a few
instances where removal was absolutely necessary, the greatest
difficulty was experienced in obtaining the parents' consent, and
in a few cases it became necessary to have recourse to the compulsory
powers of removal, such as they are, which the Sanitary
Act of 1866 confers.
It need hardly be said that a great majority of the cases were