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which 90 out of 231 recorded cases were removed for
treatment. Of the 231 recorded cases 154 belonged to that
part of the parish north of Uxbridge Road, and 77 to the
remainder of the parish south of that road. The recorded
cases in 1882 were 319. In many instances the occurrence
of the disease was concealed until recovery had taken place,
when the cases were reported in order to obtain gratuitous
disinfection; and frequently when the existence of the
disease became known at an early period, we were unable to
persuade parents to consent to the removal of their children
to hospital. In some cases, when it was too late, the refusal
came to be lamented. A certain number of patients were
well isolated at home, and their removal to hospital was
deemed unnecessary, but proofs were not wanting that,
even when the patients had what might be fairly described
as " proper lodging and accommodation," due care was not
taken to prevent the spread of the disease, unless it be the
fact that no amount of care suffices to prevent its spread
when once it has found admittance into a susceptible family.
In not a few instances, where removal was obviously
necessary to security, the greatest difficulty was experienced
in obtaining the parents' consent, but in no case did we 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 most of the cases were of
children, usually of school age, and 86 of the sufferers had
been attending school up to the time of the attack. Every
effort was made, by co-operation with school-teachers and
visitors, &c., to prevent the disease from spreading, and no
child was allowed to go to school from an infected house.
The existence of the disease was revealed often by the
registration of a death, and it is the fact that its spread
was commonly the result of keeping patients at home
under circumstances that rendered nugatory any attempts
at isolation.
From time to time cases come to light which help to