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66
second period, to the deaths from scarlet fever, we have in the
second period an absolute reduction of 193 in the deaths from
the two diseases, the reduction corrected for increase of population
being 878.
Comparing the mortality from the " seven principal diseases
of the zymotic class" in the two periods, we arrive at a corrected
reduction in the number of deaths, in the second period, of no
fewer than 1,441. In other words, had the rate of mortality from
these diseases been the same in the second period (1871-82), as
in the first period (1859-70), there would have died in the second
period of twelve years 1,441 persons more than did die, or 120
per annum. The zymotic death rate, I may add, which in
1859-70 was 3'6 per 1,000 persons living, fell to 2"8 per 1,000 in
1871-82; the deaths from these diseases, moreover, which in
1859-70 formed 18 per cent, of total deaths, were only 15'4 per
cent, in 1871-82.
Other causes, doubtless, besides notification, contributed to
bring about this satisfactory result, and we must not forget, as
regards enteric fever, that this disease, under improved sanitary
arrangements, has " continuously and notably declined in England
during recent years." Chief among these causes, and one, in my
judgment, even superior in efficacy to notification, is the provision
of hospital accommodation by the Asylums Board, under the
provisions of the Metropolitan Poor Act, 1867. So highly,
indeed, do I value this provision, that, were I offered a choice
between hospitafs and notification, I should unhesitatingly choose
hospitals; for this reason, among others, that provision of hospital
accommodation leads, almost inevitably, to voluntary notification;
whereas even compulsory notification has comparatively little
value if hospital accommodation be wanting.
INTERRUPTION OF EDUCATION AT ELEMENTARY
SCHOOLS RESULTING FROM THE PREVALENCE OF
INFECTIOUS DISEASE.
It is the practice at Board and other elementary schools to
refuse admission to children from houses where infectious disease