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disease; cases of scarlatina anginosa being sometimes erroneously
certified as diphtheria. On the other hand, it occasionally
happens that diphtheria is not recognised in the primary stage,
and the specific nature of an apparently simple throat disease
does not become apparent until paralysis supervenes. Cases of
croup, again, are sometimes described as diphtheria, and vice
versa. Diphtheria does not often show a disposition to become
epidemic, or even endemic, in the Metropolis. Occasionally,
however, when the disease occurs as a result of insanitary
conditions, it will spread in a family, and instances of this
kind were not wanting in the past year. Towards the close
of the year, there were four cases among the pupils at a High
School at Notting Hill—one of them proved fatal. Inspection of
the school, which was at once closed, revealed sanitary defects,
subsequently rectified, but not of a nature to suggest the relation
of cause and effect with the disease, which probably was spread by
personal infection. The Asylums Board do not treat diphtheria
in their hospitals, and difficulty is occasionally experienced in
obtaining means of isolation for patients who, by reason of the
circumstances of the family, or the occupation of the head of the
family, require to be removed. The Managers are in communication
with the Local Government Board with reference to the
Order of the Board, which at present debars the Managers from
admitting cases of diphtheria, and it is to be hoped that the
restriction may ere long be removed.
Fever.— The corrected decennial average number of
deaths from "fever" (i.e., typhus fever, enteric fever, and simple
continued fever) is 33, but in 1885 there was no death from
typhus fever, nor from simple continued fever, and the deaths
were 12 only from enteric fever—all of them, save one, in the
Town sub-district. The disease was less prevalent than usual
in the autumn, and there was no local outbreak of importance
at any period of the year.
Diarrhoea.—The deaths from diarrhoea, 86 in number (as
against 110 in 1881), were 30 below the decennial average corrected
for increase of population; 78 of them took place in the Town