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74
1899]
From 1861 to 1870 the death-rate from Diphtheria and Croup
averaged 358 per million of the population*, whereas in the succeeding
ten years it was only 241, a decrease of 327 per cent. In
the same periods the death-rates from Diphtheria alone were
respectively 182 and 114 per million, or a decrease of 37.4 per cent.
Thus there was practically almost a similar decline in both rates,
which showed that up to then, at all events, there had been no
change for the better in the comparison that existed between Croup
and Diphtheria. Indeed the death-rate from Croup in this period
declined only 27.9 per cent. In the succeeding ten years (1881-90) the
death-rate from the diseases taken together was 398 per million,
while that from Diphtheria alone was 253 per million. In other
words, whereas the death-rate from Diphtheria and Croup combined
increased only 65.1 per cent. that from Diphtheria alone increased
121.9 per cent., thus showing that either the deaths from Croup had
greatly decreased or that deaths which had previously been ascribed
to that disease were then more generally ascribed to Diphtheria.
At this time the death-rate from Croup increased only from 127 per
million to 145, or 14.1 per cent. In the succeeding eight years
(1891-98) the mean annual death-rate from Croup and Diphtheria
further advanced from 398 to 562 per million, an increase of 41.2
per cent. whereas the death-rate from Diphtheria alone rose from
253 per million to 487, being an increase of 92.4 per cent. But
during the same eight years the death-rate from Croup fell from 145
per million to 75 per million, or no less than 48.3 per cent.
From these facts it is self-evident that in former days great
confusion existed in the minds of practitioners as to the disease
now so generally recognized as Diphtheria, and that very many of
the deaths formerly registered as arising from Croup were really
deaths from Diphtheria.
* I have made the calculation per million so as to avoid decimals and also that
the figures given by the Registrar-General for other places may be more readily compared
with those of Islington.