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53
and advantageous course would be that the original intention
of the House of Commons be carried out by each district, or
each Parish being obliged to provide its own accommodation
for its own infectious diseases. The first interest that ought to
be considered is that of the person who is afflicted, for it is
obvious that we have no right to do individual harm by removing
patients long distances for the sake of the questionable
advantage which may be obtained through the Hospitals
being in more isolated localities.
scaelet fever.
A rather severe epidemic of scarlet fever prevailed in London
during last year. This District was also attacked rather
severely, and more particularly so during the Autumn months.
During the year, 248 cases were reported, but this undobtedly
represents only a small proportion of the cases which actually
occurred. There were 95 deaths registered from this disease,
which on the number of cases reported would give a death rate
of 38.3 per cent of persons attacked, whereas the mortality,
so far as I am able to judge from the cases I saw in private
practice was not more than 5 percent. Many of my remarks
on the means to be employed for the effectual prevention of
small.pox, equally apply to this disease. The most careful,
stringent, and systematic disinfection was carried out in every
case reported, so consequently it may be assumed that much
good was done. It may readily be perceived that any such
measures can be only palliative, while the greater proportion of
cases ;»re not reported or known of until after the death of
the patient. Nothing short of compulsory registration and
isolation could effectually cut short an epidemic of this disease.
Of the 93 deaths there were 54 in the Parish of Hammersmith,
and 41 in the Parish of Fulham.
diptheria.
Of the 21 deaths from diptheria there were 18 in the Parish
of Hammersmith and three in the Parish of Fulham. None of
these cases were reported till after death. Probably a large
proportion were not diptheiia, for two reasons: firstly, because
they nearly all occurred singly, although diptheiia is a most
infectious disease; and secondly because many affections of
the throat, the result of cold and damp, are frequently mistaken
in practice for diptheiia.