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38
is also made of the Act for the compulsory notification of infectious
disease, careful study of the working of which has led the
Committee to the conclusion that " certain amendments are
urgently required." The views of the Committee on the imperfections
of the medical certificate, approved as they are by the
Managers, will he found in the section on Notification (page 60).
A new feature in the report are the "Spot" maps of
London, shewing the localities from which patients suffering
from scarlet, enteric and typhus fevers, diphtheria and small-pox,
have been admitted into the hospitals of the Board. But
these maps, as well as the tables, are "divided according to
the boundaries of the parishes and unions responsible for the
maintenance of the patients," a circumstance which somewhat
detracts from their value, and is also somewhat inconsistant, as a
"return of cases notified" is "arranged according to the areas
of the local authorities" (vestries and district boards), "which in
some cases are not conterminous with the areas of the parishes
and unions," or poor law districts. In course of time, the Committee
" hopes to be in a position to have' maps prepared which
will shew not the admissions to hospitals only, but the total number
of cases which have been notified." The Committee refers
to " the effects of aggregating a number of cases of diphtheria 011
one site," and quotes an observation by Mr.Sweeting, late Medical
Superintendent of the Western Fever Hospital—who has advanced
evidence, "of an increased prevalence of throat illness amongst
scarlet fever cases since the reception into hospital of diphtheria
cases"—to the effect that " the whole question of this closer interrelation
of scarlet fever and diphtheria would seem to be one
calling for immediate skilled scientific enquiry" which, I would
-venture to add, might well be conducted by Mr. Sweeting himself,
now one of the medical staff of the Local Government Board.
A variety of statistical information as to admissions to hospitals in
1889, is given by the Committee, the substance of which will be
found in other portions of the present report,* printed before the
* Vide Chairman's Report (page 33) and Report ot the Ambulance Committee
(page 43).