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121
Board was duo in great measure to the increased
facilities now existing for the removal of patients to
the hospitals, and to the growing tendency on the
part of Londoners to avail themselves in the case of
scarlet fever of the means of isolation afforded by the
Metropolitan Asylums Hospitals. This tendency is
shown by the increasing proportion borne by the
hospital deaths to the deaths outside those institutions.
Thus in 1878 the deaths from scarlet fever in the
London Fever Hospital and Metropolitan Asylums
Hospitals were only 7 per cent. of the whole mortality
from that disease in London, in 1879-82 they were
from 9 to 11 per cent., in 1883 the percentage rose to
13.2, in 1884 to 17.6, in 1885 to 20.2, in 1886 to
22*7, while finally in 1887 it reached the high figure
of 36.6; that is to say, considerably more than a third
of the deaths from this disease in 1887 occurred in
these hospitals. If, as is contemplated, the managers
of the Metropolitan Asylums Board be empowered to
receive any patient suffering from fever (or smallpox)
upon the certificate of any duly qualified medical
practitioner, without the intervention of the Relieving
Officer or Medical Officer of Health, then it is to be
expected that the Hospitals of the Board will be made
use of to a still greater extent than hitherto.
As regards the extent of the epidemic in London,
assuming that the case-mortality in the hospitals
represented the case-mortality of the whole of London,