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sanitary areas, the deaths have gone up at least 50 per cent. since 1887, and in many of them
they have been doubled, and in some cases more than trebled, in that short period." I may
copy a sentence from the Annual Report of one of the London Medical Officers of Health,
which puts very clearly and concisely my own view of this disease. He says, "It may fairly
be expected that with greater agreement on the part of medical practitioners as to what
constitutes diphtheria, the notification of this disease (made compulsory since October, 1889
and the means of isolation provided by the Asylums Board Hospitals, will prevent the spread
and diminish the mortality from this disease."
Erysipelas has caused one death. This disease was first placed on the list of notifiable
infectious diseases by the Notification Act of October, 1889.
Whooping Cough has caused twenty-three deaths. In most of these cases it was found, on
inquiry, that exhaustion and convulsions had hastened a fatal termination.
Measles (complicated with pneumonia, bronchitis, and broncho-pneumonia) has caused
nineteen deaths, as against seventeen of last year.
Diarrhæa (entirely infantile) has caused twenty-four deaths. Last year the number was
thirty, and the two previous years thirty-seven and forty-four respectively, so that during the
last four years there has been a steady, perceptible decrease in the numbers of deaths from this
complaint. Whether this diminution may be partially attributed to the lower summer
temperature, or to greater care in the dieting of infants, or in conjunction with these and
other causes, a constant supply of water direct from the main, without storage in tanks, has to
be proved. This latter point may have much to do with the lessened infantile mortality due to
diarrhœa. A recent writer on hygiene says, "Infantile diarrhœa, which is so prevalent and
fatal in the large towns of this country in the warmer summer months, appears to be due to
water pollution in many cases. The polluting material, whatever its nature and origin, seems
to be incapable of producing diarrhoea until the temperature of the water, stored in cisterns
and reservoirs, has risen above 60° F."