London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Islington 1858
[Report of the Medical Officer of Health for Islington, Parish of St Mary]
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11
The sex scarcely affected the duration of the fatal cases, and the age of the patient
appeared to have equally little influence over it, except in the instance of the 4 infants
under 1 year, included in Class 1. The mean duration in these four cases was 4 days;
at each of the other ages the mean duration before death was from 9 to 11 days.
26.
| Class 1. | Class 2. | Class 3. | Total. | |
|---|---|---|---|---|
| From extension of the disease to the larynx, oedema of the glottis, or suffocation | 22 | — | 5 | 27 |
| Sudden | 4 | — | 6 | |
| From exhaustion | 20 | 2 | 23 | |
| ,, disease of the brain | 1 | — | — | 1 |
| „ convulsions | — | 1 | 2 | |
| ,, suppression of urine and dropsy | 1 | — | — | |
| Total | 48 | 2 | 9 | 59 |
These numbers will also assist in determining the periods of the disease at which these several modes of death are imminent. The following table embraces 58 cases :—
| 1st Week. | 2nd Week. | 3rd Week. | 4th Week. | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Laryngeal Complication. | Sudden. | Exhaustion. | Brain Disease. | Convulsions. | Laryngeal Complication. | Exhaustion. | Convulsions. | Suppressed Urine. | Laryngeal Complication. | Sudden. | Exhaustion. | Exhaustion. | |
| Class 1 | 15 | 2 | 7 | 1 | — | 7 | 7 | — | 1 | 1 | 2 | 2 | 4 |
| Class 2 | — | — | — | — | 1 | — | — | — | — | — | — | — | |
| Class 3 | 3 | 1 | — | — | — | 1 | 1 | 1 | — | — | — | 1 | — |
| Total | 18 | 3 | 7 | 1 | 1 | 8 | 8 | 1 | 1 | 1 | 2 | 3 | 4 |
The danger from which a fatal result is mainly to be apprehended in the course of
the first week of the disease, is extension of the latter to the upper part of the air
passages, and consequent suffocation. The sudden deaths in this week are probably
due to the same cause giving rise to spasmodic closure of the glottis. As the malady
advances into the second week the chances of death from this cause are only equal to
those from the general prostration of the vital powers. In the third and fourth weeks,
the latter is the condition chiefly to be dreaded; the sudden deaths at this time are
probably due to syncope or fainting.