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146 ON THE SANITARY CONDITION OF
and the defective character of the ventilation, lead to
an intensifying of the poison and to a distribution of
the disease among those who are more liable to the
disease than older persons.
I have carefully considered the 79 cases notified in
this district. The Medical Officer is not expected to
visit cases unless there be some special attendant
circumstances, therefore it may be that some of these
cases were not suffering from diphtheria,* but undoubtedly
there may have been a number of mild cases
unnotified. 51 of the cases were among children under
10 years of age, and of the remaining 27, 15 were
females; showing that the spread of the complaint
is confined to women and children who are necessarily
thrown more together than are the men, who
thereby escape much of the risk of infection and at
the same time are removed from the influence of the
possible insanitary condition of the dwelling house.
27 of the cases were in St. Anne's District, 25 in St.
Mary's, and 26 in St. Clement's. In the first-named
they were for the most part isolated cases, but in the
other two Districts cases were grouped more in the
narrow and crowded streets. In 25 of the premises in
which cases occurred works of sanitary improvement
were necessary. Examined as to the distance of street
sewer ventilators from houses affected, it appeared that
the larger number were beyond 50 ft. from a ventilator,
but one cannot say if the children played over these
ventilators; and if they did, what effect might be produced
thereby. Investigations are in progress by the
*One case I was led to visit from it being certified to be one of both diphtheria
and small pox. I saw no evidence that the person was suffering from either of
these diseases.