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extreme contagiousness of diphtheria, and the fact that in many
cases there was practically no isolation. A partial explanation of
the comparatively non-fatal character of the later cases notified as
diphtheria may be found in the fact that an increasing proportion
of them occurred in persons above five years of age, many
being adults. The danger of spread of true diphtheria was painfully
illustrated in one family of four children, aged 1,2, B, and 4,
years respectively, all of whom succumbed to the malady. The
first case had been notified as scarlet fever, but prior to death the
diagnosis was corrected. The father would not allow the body to
be removed to the mortuary. Subsequently the other three
children were attacked and removed to hospital, where they died.
Other illustrations may be found in several of my monthly
reports.
The deaths from diphtheria in London numbered 1417
(about 355 above the corrected decennial average), being 200
fewer than in 1889, a year characterised by the highest death-rate
on record from this disease. Fortunately, the hospitals of the
Asylums Board were open for the reception of patients, otherwise
the deaths would probably have been far more numerous.
It was in more than one or two cases matter for regret that parents
would not consent to the removal of a first case, which would
have prevented the spread of disease, and fatal results that might
have been avoided.
WHOOPING-COUGH.
The deaths from Whooping-cough in 1889 were 26 only—the
lowest number on record, after correction for increase of population.
The actually lowest number (22) was recorded in 1863, but the population
then was less by 100,000 than in 1889. The deaths from
this cause having been so few in 1889, it is not surprising that
the mortality should have been in excess in 1890, when 93
deaths, or 7 above the corrected decennial average, were registered;
eight of them in the Brompton sub-district. All but two were of