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London from this cause in 1880 were more than twice as
numerous as in 1887, and yet we had then no such alarm. The
reason is not far to seek. People did not use the hospitals
seven years ago as they do now. The bulk of the sick were
kept at home. Most of the deaths occurred in private houses,
and so there was no particular strain on the hospitals to awaken
public attention to the epidemic. Take our local experience by
way of illustration. In 1887 our home treated cases were 316
out of 466 cases recorded, only 150 cases having gone to
hospitals; whereas in 1887 the home treated cases were only
149, the cases removed to hospital being 316—an exact reversal
of the figures of 1880. The percentage of removals, which in
the latter year was 32, had risen in 1887 to 68. The percentage
of deaths in hospitals, which was 21 in 1880, rose to 52 in 1887.
And what is true of Kensington cases is no doubt true in the
main in regard to cases in all of the other Metropolitan districts.
STATISTICAL RETURNS.
The Asylums Board addressed a circular letter to the
Vestries and District Boards, in October, making application for
information to enable them to ascertain " the extent, as compared
with previous years, to which scarlet fever had been prevalent
during the year " in the several districts, their object
being to form " as correct an estimate as possible of the accommodation
to be provided in future" for cases of this disease.
The reason for inquiry was " the difficulty of obtaining reliable
information on the subject in the absence of any system of notification
of infectious disease"—a difficulty enhanced, perhaps,
by the fact that although " the numbers of patients under treatment
in the hospitals " were in October " more than double the
numbers under treatment at any one time during the past ten
years," yet " the mortality . . . was below, rather than
above, the general average." It was reasonably assumed,
however, that as the deaths in the hospitals " form, year by
year, an increasing percentage of the total number of deaths, . . .
the numbers in the hospitals had also assumed a correspondingly
increased proportion of the total number of persons attacked in
the Metropolis."