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42
DIPHTHERIA.
The notified cases of diphtheria (360), and membranous
croup (11) which the Registrar-General now classifies as
diphtheria, were 371, against 368,268, and 365, in the preceding
three years; viz.: 222 in North Kensington and 149 in South
Kensington. The deaths registered were 72 (against 83, 75,
and 89, in the preceding three years respectively), and 10
above the corrected decennial average: 46 of them belong
to the Town sub-district and 26 to Brompton; 44 to North
Kensington, and 28 to South Kensington. Thirty-four of the
deaths took place at hospitals, to which 231 cases were
removed, and 38 at home. The case-mortality was 19.4 per
cent., and was much higher in the home-treated cases (27.1 per
cent.) than in cases removed to hospital (14.7 per cent.) Of this
striking difference, I am unable to suggest any other explanation than the antitoxin treatment, which is practised, doubtless,
to a larger extent at the hospitals than in the cases treated at
home. In 1895, the first year of antitoxin treatment, the
case-mortality in home cases was 34.2 per cent., in hospital
cases 20.1 per cent.; whilst in 1894, the case-mortality was
practically equal in home and hospital cases, viz., 28.3 and
27.7 per cent. respectively. It must be remembered, moreover, that the percentage mortality in hospital cases is
calculated upon true diphtheria, whereas in home cases the
calculated mortality is based on notified cases—a very different
thing, having regard to the large proportion of cases of mistaken diagnosis ; so that the proportional success of treatment
at the hospitals is even greater than represented by the most
favourable figures.
The deaths in London from diphtheria were 2,683 (797
above the corrected decennial average, 1,886), as compared with
3,265, 2,670, and 2,316, in the years 1893, 1894, and 1895,
respectively. Of the 2,683 deaths 956 occurred in the
hospitals, to which 4,580 cases of true diphtheria were
removed—a mortality of 20.9 per cent. The deaths in