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The number of deaths from diphtheria in London during
the year 1885, was 896, of which 202 occurred in the first
quarter, 213 in the second quarter, 238 in the third quarter,
and 243 in the fourth quarter. The total exceeded the
average of the previous 10 years, which was 690. It was,
however, less than in the two preceding years, —the deaths
in 1884 being 973, and in 1883, 951.
During the present year the number of deaths from
diphtheria, in London was 220 in the first quarter, and 188
in the second quarter. In the last six weeks, the weekly
numbers have been 13, 15, 20, 28, 18, 25. The last number
is 7 above the average, which is 18 for the corresponding
week in the previous 10 years.
I am unable to suggest any course by which the Sanitary
authorities could prevent the occurrence of this disease, but
have no doubt that the number of fatal cases might be
reduced by prompt medical aid. It is a complaint in which
the early symptoms are not strongly marked, and, consequently,
it often happens that a doctor is not called in until the
condition of the patient has become dangerous or even
hopeless.
The death rate from diphtheria in London last year was
0.22, or 22 deaths from this cause in one hundred thousand
of the population.
This disease has a distinct maximum period in the
last quarter of the year. The highest point is generally
reached about the end of November, when it gradually
declines till about the first week in May. It is frequently
more prevalent in the extra-metropolitan parts of Surrey
and Middlesex, and in some of the country districts, than it
is in London.
The Registrar-General remarks that, " So much uncertainty
attaches to the use of the term " diphtheria" by medical
men, and there is such confusion in their certificates between
diphtheric and simple spasmodic croup, that the returns
under this heading are extremely untrustworthy."
Diphtheria is as prevalent just now in the healthy districts
of the West End as it is in the less healthy parts of East
London.