View report page

8
As regards the spread of diphtheria, the source of infection
could rarely be ascertained. There has not been any outbreaks
this year connected with schools, although occasionally I have
had some suspicion that the disease may have been contracted
in the playground. There has not been any unusual prevalence
amongst the pupils in any school classes, and I must say that
with the exception of scarlet fever, there has been but little
evidence in this district of infectious disease being contracted in
the school rooms. Sanitary defects have sometimes been found in
the houses, but more often not, so that I cannot ascribe the attacks
to this cause, although sore throats are very frequently met with
in badly drained premises. I believe, however, that the course
and severity of the disease are considerably modified by the
sanitary surroundings. The connection between sore throats and
diphtheria is doubtful, as although the former usually begins and
ends without diphtheritic exudation taking place during the inflammatory
stage, and without paralysis after an attack, yet
occasionally I have known diphtheria to occur in the course of
what has seemed to be an attack of ordinary inflamed throat.
The development of diphtheria seems to be caused by some
condition of the patient, which renders the recipient more
susceptible than usual to the diphtheritic poison, as for instance,
an inflamed membrane is more liable to receive infection than a
healthy one. In my last report I alluded to a connection
between diphtheria in cats and adults, and the researches of
Koch seem to prove the validity of my belief that children
might give the disease to cats, and also that cats might infect
human beings.
Influenza.—Considering the large number of persons attacked
with this disease the mortality was small, but a considerable
number suffered for a considerable time from great languor and
debility. I have not any means of judging as to the numbers
attacked, but they must have amounted in this district alone, to
thousands. The total deaths were only 31, of which 3 occurred
between 1 and 5 years of age, 2 between 5 and 15, and also
between 15 and 25. The number then rose to 6 among the
persons aged between 25 and 35, 3 between 35 and 45, 2