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from the Boys' Home, Shaftesbury Avenue, where a sudden
but mild outbreak of the disease occurred between the end
of January and the 14th of the following month.
During the year 1889, the number of scarlet fever
patients in the several hospitals of the Asylums Board
amounted in the aggregate to 5,260, of whom 366 died, a
mortality of 6.9 per cent.
"The past year showed a further advance in the increasing
tendency of Londoners to make use of the public hospitals
in cases of scarlet fever, for, in 1878, only 7 per cent. of
the total deaths from this disease occurred in the London
Fever and Metropolitan Asylum Hospitals, from which date
the proportion rose year by year, until in 1888 it had reached
43 4 per cent.; again, in 1889, to rise further to 48.9 per
cent., or practically one half of the whole" (RegistrarGeneral).
4. Diphtheria (decennial average 12.9).—The 17 deaths
from this disease in 1889, 15 children and 2 adults, showed
an increase of 6 over the number reported for the preceding
year. In the whole Metropolis, the deaths of 1,588 were
referred to diphtheria; of these, 1,055 were children under
5 years of age.
The Registrar-General reports:—"The mortality from
this disease, which has been increasing steadily for many
years, but in the last two years, 1888 and 1889, made the
most alarming bounds, the deaths rising from a total of 953
in 1887, first to 1,311, and then in 1889 to no less than
1.588, whereas the decennial average, after corrections for
growth of population, was only 932."
Isolation is most important in this disease, as undoubtedly
it is spread from person to person. Again, every case of