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mix with those who were healthy, and so the disease spreads,
this occurs more amongst the uninformed ; as far as we possibly
can we try to minimise the spread by directions as to disinfection,
&c., but in many cases a medical man is only consulted
once, when he notifies the case to me, and frequently on the
house being visited the patient is found playing about the
streets, sowing infection broadcast. I think, when a favourable
opportunity arises in the future, some stringent measure
should be taken to shew the parents of these children their
duty, and a prosecution instituted to prevent this wholesale
spread, it would no doubt have a salutary effect.
Diphtheria.
Five hundred and thirty-seven cases have been notified to
me during the past year as against 512 of last year; judging from
the mortality the disease must indeed have been of a mild
character, seeing that there only 78 fatal cases. 154 were
treated in the various hospitals.
The origin of this disease still remains obscure; that it is a
septic disease admits of no doubt. In all cases the house
drains are tested, the numbers being, 408 tested, 81 of which
were found defective, so that we cannot say it is wholly caused
by defective drainage.
Diphtheria and Scarlet Fever were so prevalent throughout
the metropolis during the summer months that the Asylums
Board Hospitals were full, and a large number of cases had to
be treated at their homes, in many of these instances to the
danger of other occupants of the dwelling, last year the same
state of things occurred. Surely this ought not to be in a city
like London, with its ever increasing population, that year after
year the authorities should be in this serious position.
Typhoid Fever.
The number of cases of Typhoid Fever notified to me during
the year was 115, 16 of which proved fatal there can be no
doubt that inhalation of sewer gas plays an important part in
this disease, and whether it is from the house drains or from
the sewers in the street, it is equally certain that in either of
the instances it is highly detrimental to health. The number of