London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
St Pancras 1894
Report upon the cause of the increae of mortality from diphtheria in London
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From this table it appears that there has been a very marked fall in the
number of deaths from thrush and croup, a distinct but less marked fall in
those from laryngitis and other diseases of larynx and trachea, and an
irregular and slight decrease under the head of sore throat, only observable
on comparing the quinquennium 1881-5 with that of 1886-90. All these
diseases, taken together, show progressive and very distinct fall in the number
of deaths attributed to them. Diphtheria on the other hand shows a
progressive and distinct rise, in fact, when compared side by side, the numbers
of the two classes proceed in inverse ratio, and when the two classes are
totalled together any increase disappears. Thinking that the influence of age
incidence might have affected the result, I extracted the deaths from the
several diseases and classified them in two categories, under 15 years, and
15 years and over, the incidence of diphtheria being greatest under 15 years.
The result is shewn in the following table:—
(Extracted from tables of Causes of Deaths at different periods of life, Male and Female, in Registrar's General Annual Reports).
| Year | Total throat diseases. | Diphtheria. | Total throat diseases other than diphtheria. | Thrush. | Croup. | Laryngitis. | Other diseases of larynx & trachea. | Sore throat, quinsy. |
|---|---|---|---|---|---|---|---|---|
| 1881 | 1741 + 146 | 607 + 50 | 1134 +96 | 164 + – | 663 + – | 209 + 51 | 31 + 21 | 67 + 24 |
| 1882 | 2174 + 144 | 808 + 45 | 1366 + 99 | 110 + – | 867+ 1 | 2 54 + 58 | 45 + 10 | 90 + 30 |
| 1883 | 2210 + 172 | 892 + 60 | 1318 + 112 | 132 + 2 | 824 + – | 229 + 54 | 29 + 17 | 104 + 39 |
| 1884 | 2124 + 171 | 883 + 68 | 1241 + 103 | 119+2 | 730 + – | 263 + 44 | 30 +19 | 99 + 38 |
| 1885 | 1972 + 128 | 854 + 50 | 1118 + 78 | 104 + – | 690 + – | 218 + 46 | 21 + 5 | 85 + 27 |
| 1886 | 1732 + 141 | 798 + 53 | 934 + 88 | 118 + – | 530 + – | 202 + 46 | 15 + 13 | 69 + 29 |
| 1887 | 1926 + 155 | 901 + 52 | 1025 + 103 | 80 + – | 625 + 1 | 219 + 40 | 28 + 18 | 73 + 44 |
| 1888 | 2141 + 138 | 1242 + 69 | 899 + 69 | 62 + – | 501 + – | 215 + 36 | 33 + 8 | 88 + 25 |
| 1889 | 2370 + 140 | 1546+ 70 | 824 + 70 | 84+ – | 458 + – | 188 + 30 | 24 + 17 | 70 + 23 |
| 1890 | 2186 + 187 | [320 + 62 | 866+ 125 | 92 + – | 505 + – | 180 + 54 | l8 + 18 | 71 + 53 |
| 1891 | 2010 + 173 | 1369 + 64 | 641 + 109 | 70 + – | 339 + – | 153 + 57 | 20 + 13 | 55 + 39 |
This table shows how little the numbers of deaths at 15 years of age and
upwards affect the results. The numbers are few, but comparing the quinquennium
1881-85 with that of 1886-90, although there is an increase of 33
deaths from diphtheria, and a decrease of the same number from other throat
diseases, equal only to 3'3 a year, the total numbers remain the same in the two
quinquennia, showing a stationary number of deaths from all throat diseases
at and over 15 years of age, and taking increase of population into account,
an actual decrease of mortality. If we turn to the numbers under this age,
we find the figures of the previous table, which are large, are corroborated by
the enormous increase in the number of deaths attributed to diphtheria, and
the decrease in the number from other throat diseases, and comparing the total
number of deaths from both classes under fifteen years of age in the first
quinquennium with the second there appears only an increase of 134, equal
to 13.4 per annum, or taking population into account, also a decrease in the
mortality.