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86
allow her child to be taken to a hospital. The latter two cases
would have in all probability been prevented had the first case been
reported early and removed to a hospital.
The Royal Hospitals Commissioners which were appointed at
the end of the year 1881 have published their report to the House
of Commons, but 110 action has as yet beea taken by the
Government to bring in a Bill to provide for the proper and prompt
isolation of infectious diseases. The recommendations of the Commissioners
have been presented to your Board and. published in my
fourth quarterly report for last year. It is not therefore necessary
for me to deal further with the subject in this report.
Scarlet Fever.
During last year scarlet fever was slightly less prevalent in
London than in the previous year, there being 2004 deaths registered
against 2108 in the year 1881. In the Fulharn district
there was a greater number of cases reported last year than in the
year previous. The number of deaths registered in this district
last year was 85 against 65 in the year previous. These 85 deaths
were equal to 3.4 per cent of the total deaths registered and were
equivalent to an annual rate of .7 per 1000 persons living. The
deaths from scarlet fever in London were equal to 2.4 per cent of
the total deaths registered and were equivalent to an annual rate
of .5 per 1000 persons living. Altogether there were reported
last year 281 cases against 248, 180, 152, and 228 cases reported in
the four years 1878-1881 respectively. These numbers do not
represent all the cases that occurred in this district because a very
large proportion are treated at home and never reported to your
Sanitary Department at all. Of the cases reported last year there
were 106 in the parish of Hammersmith against 140 in the previous
year, and 175 in the parish of Fulharn against 88 in the previous
year. There was therefore a decrease of 34 cases in the parish of
Hammersmith, and an increase of 87 cases in the parish of Fulham
last year as compared with the previous year. It is worthy of
note that with the opening of the Western District Hospital at
Fulham for fever cases there has been a great increase in the
number of cases of fever in the Fulham parish. It would not be
correct on this account to assume that the disease has spread from
the hospital as it has been open too short a time for the
fact to have much practical significance. In 73 of the 85
cases in which death took place the first information was obtained
in the death returns. 24 of the cases were not reported until
after the recovery of the patients. In 138 cases the patients or
their relatives refused the offer of removal to a hospital. The
accommodation in many of these cases was not sufficient for the
effectual isolation of the disease but was not so bad as regards the
provision for the treatment of the patient that a magistrate's order
could be obtained to enforce the removal. 48 patients were removed
to hospitals, 11 to the "Western District Hospital at Fulham, and
37 to the South Western District Hospital at Stockwell. Of the