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In perusing the foregoing Tables it will be observed that there Was a considerable
increase in the death-rate from diphtheria in 1892, and in 1893 it rose
to serious epidemic proportions, and since then has only moderately fallen.
Previous to this recent rise in the mortality, the increased prevalence of
diphtheria appeared as a displacement of other existing throat diseases; but
the recent rise has proceeded far beyond that point, and this is seen clearly in
the column of mortality from all diseases of the throat in which the number in
London is seen almost to double in (he year 189'J.
DIPHTHERIA NOMENCLATURE.
At various times difficulties have been experienced in obtaining the removal
to hospital of cases of diphtheria, or its congeners. In order to settle a
question as to nomenclature, a letter was addressed to the Clerk to the
Metropolitan Asylums Board, and by that Board the question was submitted
to the Local Government Hoard. As the matter is important, the letter to
the Clerk to the Metropolitan Asylums Board and the reply of the Local
Government Board are set out below. They are self-explanatory.
Vestry Hall,
Pancras Road, n.w.,
31stf December, 1896.
T. Duncombe Mann, Esq.,
Norfolk House, Norfolk Street, Strand, W.C.
Dear Sir,
Diphtheria—Membranous Croup.
At various times when your Board has been asked to remove to hospital
cases of Membranous Croup, return enquiries have been made as to whether
the cases have been Diphtheritic in character, and I have been informed,
through the telephone, that your Board declines to remove cases of Membranous
Croup.
Referring to the third edition of the "Nomenclature of Diseases," published
by the Royal College of Physicians, London, 1896, I find in the list of
diseases, and numbered 14, Diphtheria—variety: Laryngeal Diphtheria.
Synonym : Membranous Croup.
It is obvious that, in the.opinion of the Royal College of Physicians, Membranous
Croup is Diphtheria of the Larynx. I would ask you, therefore, to
kindly inform me whether since the publication of the above " Nomenclature "
your Board admits Membranous Croup (unqualified) to your hospitals, and I
should esteem your answer the more, as a solution to this question is extremely
important in working the infectious diseases notification section of the Publio
Health (London) Act.
Yours faithfully,
JOHN F. J. SYKES.