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65
ventilator, wrongly known as an inlet, is a device that effects this
exposure to an infinitely greater degree than even faulty drainage
of an older type. In a word, I am of opinion that the phenomena
of the differential incidence of diphtheria displayed in the chart
is in some measure accounted for by the defective type of
drainage compulsorily adopted in new districts.
I wish not to be misunderstood in saying this. I am
convinced that there is great misapprehension as to the cause of
diphtheria, and much needless alarm as to the condition of the
drainage when a case of diphtheria occurs in a house. Diphtheria
is not caused by "bad drains," and probably in every case where
a child develops the disease it has caught it by exposure to
infection from another child suffering from the same disease.
But exposure to sewage emanations does, in my opinion, as is
traditionally believed, predispose to throat infections. To live in
an atmosphere polluted with sewer gas is, other things equal,
to be predisposed to diphtheritic infection. It is on this ground
and in this way that I account for the remarkable endemicity of
diphtheria in the lower lying areas of West Willesden.