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to ascertain the cause of the disease in order that further
steps may be taken for its prevention instead of merely
continuing to extend the accommodation for treatment.
After the prolonged and extended experience of the
Metropolitan Asylums Board that body has apparently
come to the conclusion that notification and isolation have
not had the desired effect of keeping the disease under
control, but that greater advantage is to be gained by more
attention being paid to research than to the persistent
expenditure of vast sums on buildings, etc.
From the statistics prepared it would appear that in the
Metropolitan Area the annual revenue expenditure at the
Asylum Board's Fever Hospitals since 1890 has considerably
increased, being more than three times as great during the
year 1906, whilst the number of cases and attack rates per
thousand of the population vary but slightly.
Diphtheria.—Eighty-three cases of this disease were
notified, representing an attack rate of 1*6 per thousand
inhabitants: against 55 cases last year with a rate of 11,
the average rate for the past ten years being 11.
Sixty-two of the patients were removed to the Hospital,
which constitutes 74 per cent, of the total number notified,
several of the cases at the time of removal being in a very
critical condition which necessitated the operation of
tracheotomy being carried out immediately on their arrival
there
Six deaths were registered from the disease, all occurring
in the Hospital, giving a death-rate of 11 as against '18 last
year and an average of '16 for the previous ten years. In
Table C. on page 5 will be seen the death-rates for these
years.
The cases were distributed fairly evenly throughout
the Borough, and 46 were of children attending the following
schools:—
Queen's Road, 12; Holy Trinity, 7; Effra Road,
6; Dundonald, 5; Roman Catholic, 3; Haydon's
Road, 2; Central, 2; Cottenham Park, 1; Private, 6;
and schools outside the Borough, 2;
What may be termed a distinct local outbreak occurred
in July and August of children residing in Cross
and Derby Roads and adjoining portions of Russell and
Palmerston Roads who attended Holy Trinity Schools.
The evidence pointed to the infection having been conveyed
by one child who was thought to be only suffering from a
simple cold.
The maximum weekly number of cases notified was in
the third week of September and the first week of October
when 5 and 7 cases respectively were notified from houses in
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