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6
ailing from so slight a sore throat that he did not
think it necessary to consult his medical attendant.
Within a few days he got better and made his
usual journey to London, travelling in a railway
carriage and performing his daily work in his office.
He continued to do so for more than three weeks.
Feeling unwell after that time he consulted his
medical adviser, who found him in a perfect state
of desquamation, and therefore came to the conclusion
that the patient was all the time suffering
from scarlatina." I then received a notification to
that effect. This is by no means an isolated case,
as similar cases have previously come under my
notice and it proves the difficulty of stamping out
this disease, whatever preventive measures may
be adopted.
In all cases the usual measures were taken to
prevent the spread.
Diphtheria.—Nineteen cases have been reported
and three proved fatal, against 22 with 8 deaths
in the previous year. Fourteen were children
over 5 years or grown up persons, and this accounts
for the small mortality, the disease being
more fatal in very young children. Many of the
cases were of a mild type and a majority (15) occurred
in the first six months of the year, when
we had a great deficiency of rainfall. It was
observed in other localities that a very dry season
is influential in the causation of diseases of the
throat and infantile diarrhœa, which are generally
prevalent in consequence of the absence of the
natural beneficial flushing effects of rain, by which
streets, courts, pavements, gullies and drains are
frequently cleansed and their accumulations of
dirt and decomposing matter more effectually
removed than by water cart flushing, although the
latter will always prove beneficial. Schools had