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in large numbers in the throat and mouth of the patient. Thus
diphtheritic children licking slates or exchanging sweets from
mouth to mouth are far more likely to spread the disease than a
defective drain. The difficulty of controlling such a disease is
further enhanced by the fact that the germ may remain dormant
but infective for many weeks in the throat of an apparently healthy
person, or a person suffering from an ordinary sore-throat.
Children may thus return to school, etc., apparently recovered
from an attack of Diphtheria and yet be infectious to others.
The age and sex incidence and seasonal occurrence of Diphtheria
in 1899 is shown in the following figures:—

In two cases notified the age of the patient was not given.
Oi the total of 195 cases of Diphtheria 87 occurred in males and
108 in females.
The following table shows the seasonal occurrence of the cases
of Diphtheria notified to us :—

Phthisis.-The total deaths due to Consumption or Phthisis
were 163 giving a death-rate of 2*46 per 1,000. 1 he London rate
was 1*82. There are some ten metropolitan districts which had a
Phthisis death-rate higher than that of Clerkenwell, among them
being Holborn (3-08), and St. Luke's (3-53). Notwithstanding this
fact there can be no doubt that a very large number of cases of
this disease occurring in this parish ought to be prevented. Phthisis
and other lung diseases allied to it cause a number of deaths out
of all proportion to other diseases, which though more feared by
the public really have a much less fatal effect. I hese differences
of death-rate in Clerkenwell are set forth in the tollowing graphic
form :—