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the hospitals, and, if successive decennia be compared with their
immediate predecessors, was indeed greater in the decennium
1861-70, which preceded the opening of these hospitals, than in
1871-80, the decennium which followed it. Whatever,
therefore, may be the cause why London does not improve in its
relation to small-pox to the same extent as the provinces, it is
something that came into operation long before the hospitals were
opened." Granting this, I have no doubt, in my own mind, that
the diminution in small-pox mortality in the Metropolis, last year,
was due largely to the perfected system of removing the sick direct
from their homes to the Ship Hospitals, situated as these are outside
the London registration District—a system which, as your Vestry
is aware, was instituted upon my recommendation made to the
Asylums Board and the Local Government Board in 1881. In
evidence of the success of the Asylums Board in effecting the
removal of the sick from London, it may be mentioned that 19
of the 24 deaths from small-pox occurred at the Hospital Ship
at Dartford. Of the remaining five deaths, two occurred at the
London Small-pox Hospital at Highgate, and three only in private
houses—viz., one each in Marylebone, Camberwell, and Deptford.
The Hospital Ship "Atlas," it may be mentioned, was in
use throughout the year, but the patients in the latter half of
the year were few in number.
Measles.—The deaths in 1886 from measles were 56 (six
only in Brompton), or just half the number recorded in 1885, and
19 below the corrected decennial average. Fifty-two of the deaths
occurred under five years, including 7 under one year. The
disease appears to have prevailed in a moderate degree throughout
the year, seeing that in two only of my thirteen four-weekly reports,
it did not appear as a cause of death. In the majority of the
fatal cases, some intercurrent disease—of the respiratory organs
usually—complicating the original malady, was the immediate
cause of death. Comparatively little care is taken by parents
among the poorer classes to prevent spread of measles: not
regarding it as a serious disease, and considering it inevitable as