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81
The number of cases is less than it was last year, 58 were
between 1 and 5 years, 41 were between 5 and 15 years, compared
with 62 and 61 in 1909.
The number of deaths this year shows a slight increase, 4 were
under 1 year, 14 were between 1 and 5 years.
The cases treated in the fever hospitals of the Metropolitan
Asylums Board were 106 with 7 deaths, that is 6·6 per cent.
The cases treated in the general hospitals were 19, with 12
deaths, or 63 per cent. of the whole number.
The percentage of deaths, therefore, of Finsbury cases of
diphtheria in 1910 in general hospitals was nearly 10 times as
great as the percentage of deaths when the cases were treated
in the fever hospitals of the Metropolitan Asylums Board.
Seventeen of the cases were treated in one general hospital
with 10 deaths-or 58 per cent. of the whole number.
These figures raise another question.
What is the cause of the difference in results?
Why is diphtheria more fatal when treated in general hospitals
than it is when treated in the hospitals of the Metropolitan
Asylums Board?
There are probably many reasons for this.
1. Some of the cases taken to general hospitals are cases
requiring urgent tracheotomy, and in these the percentage of
deaths is high.
2. Nearly all the cases of diphtheria at the present day are
taken to fever hospitals, so that the staff of a general hospital
are now deprived of those opportunities of gaining experience
of the disease which they had in former days.
The number of cases that will thus fall to any one physician
or assistant physician in a year is very small—possibly 4 or 5
at most—a quite insufficient number to enable him to have
extended or much profitable experience.
3. Serum treatment.—The earlier this is undertaken the
better the prospect of recovery. The requisite amount to be
injected requires much judgment and prolonged acquaintance
with the subject. Even in comparatively recent years, in some