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35
there has been a very considerable increase in the number of cases
of Diphtheria, not only in the Greenwich District, but over the
whole of the Metropolis. Last year there were 43 cases
only reported, and 9 deaths. This year 170 cases and 51
deaths. The greatest number (36) occurred in October, and the
smallest (4) in February. It is difficult to state the cause of so
large an increase. The subject is receiving marked attention from
scientific men.
It is strange that whilst formerly it was more prevalent in the
rural districts, now it appears to affect the urban most. Dampness
and stagnant water appear to be "the chief causes, and it is largely
spread by means of School influence.
In the Greenwich District most of the cases were confined
to young children of school age. Some years ago this disease
used to be confined to the eastern part of the Parish, especially
in the Marsh district, but this year it has visited every part. I
believe that, owing to the highly infectious character of this
disease, it is largely spread in Schools, and an example of that
kind occurred quite recently, in which a large number of cases
were traced to a particular School in the district, and it was not
till the School was closed that the number of cases diminished.
The following extract is taken from the Registrar-General's
Annual Summary:—
"The deaths attributed to Diphtheria numbered 3,265, and
were in the proportion of 0.76 per 1000 living, this being by far
the highest rate yet recorded, and exceeding the average in the
previous decennium by no less than 0.46 per 1000. The