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caused by insanitary or other conditions may possess or acquire infective
properties, and in passing from person to person may also acquire such
virulence as to cause death from infectious sore throat of a type which the
clinician would certify as diphtheria, whatever the pathologist might declare
it to be as the result of bacteriological examination.
Since this Report was written, figures up to a much later date have been
obtained, and these are of extreme interest. In the first place, comparison of
the mortality rates of scarlet fever, diphtheria, and enteric fever does not
coincide with our previous experience.

Contrary to our experience, as seen in the previous table up to 1890 quoted
from the Report, the last four years show that the mortality of diphtheria has
taken to epidemic fluctuation like scarlet fever, and is no longer comparatively
steady like enteric fever. Further, unlike previous years, the rise and fall of
the mortality of scarlet fever and diphtheria have occurred simultaneously.
Again, in reference to the proportion of the mortality from throat diseases
caused by diphtheria, the experience of the past four years is not quite
according to previous experience.