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72
to a diminution under the heading "croup," which is separated
from diphtheria and classified with respiratory diseases.
As a proof how terribly fatal diphtheria is amongst young
children, the Salford Hospital report states that of a total
of 118 cases admitted the percentage mortality was 31.4.
In the twelfth annual report of the sanitary condition of
the Borough and Port of Ipswich the following question is
asked as to the prevalence of diphtheria :—" Is the disease
lurking in our sewers, and have the emanations from the
sewer gratings anything to do with its wide prevalence?
There is no doubt that young children are often seen playing
near the sewer ventilators in the roads, and stooping over
the street-gulleys looking for lost balls and tops, in which
position they are very liable to receive whiffs of sewer gas."
At the International Medical Congress held at Berlin in
August last, the subject of the measures to be taken in
averting the spread of diphtheria was discussed in the
section of hygiene. The cause of diphtheria is held to be
a bacillus, which, contained in the exudation on the affected
mucous membranes, is liable to be disseminated in the
vicinity of the patient, together with particles of the false
membrane. The infectivity of the patient may even persist
for a few days after all traces of diphtheritic exudation have
disappeared. The strictest isolation of cases is necessary,
and children who have suffered from the disease should be
kept from school for at least four weeks. The bacilli have
been found to retain their vitality in dry membranes for
from four to five months. It is therefore essential that all
clothing, bed-linen and utensils likely to have been contaminated,
should be disinfected, either by boiling or by exposure
to steam. The room occupied by the patient should
be disinfected by washing the floors with warm sublimate