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record, were no fewer than 5,262, or only about 650 less than
in the epidemic year 1887. These numbers were far exceeded
in 1892, the admissions having been 13,093, or 7,193 more than
in 1887, although the deaths from scarlet fever (1,174) were
269 fewer than in 1887, and 60 below the corrected decennial
average.
If the demands, for scarlet fever only, upon the accommodation
provided by the Managers, were so great, under the
circumstances above set out, it may well be asked, What would
the requirements be, should the Metropolis be again afflicted
with an epidemic like that of 1870, when the deaths from
scarlet fever were 6,040, out of a population of millions ?
or even like that of 1880, when the deaths were 3,100, out of a
population of 3¾ millions ? In the former year there were
no hospitals : the epidemic ran its coarse without check, and
I do not expect ever again to see such a terrible death-roll
from scarlet fever in London. In 1880 the hospitals were in
operation ; the scarlet fever admissions, however, were under
2,000, and less than two-thirds of the number of deaths in
London from this cause ; whereas in 1892, with a population of
4¼ millions, the admissions were eleven times as many as the
deaths; 61 per-cent. of which took place in the hospitals:
the maximum number of patients in hospital at one time, in
November, exceeded 4,000. It must be manifest from these
figures that the demands of scarlet fever alone, are by no means
unlikely to require for their satisfaction in the future, a number of
beds equal to one in the thousand of the population ; say 4,300.
A further allowance will have to be made for enteric fever and
diphtheria. The average annual number of deaths from
enteric fever in the ten years 1882-91, was 740. In 1892 the
deaths were 436 only, the notifications of cases 2,509, and the admissions
to hospitals 622. This disease is markedly on the decrease
in London. Diphtheriaon the other hand, is markedly
on the increase. The notifications of this disease, which had been
5,907 in 1891, were no fewer than 8,064 in 1892: the deaths