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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The following table is constructed to show the mode of death of 59 patients at various ages.
| AGES. | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Under 5 years. | 5 to 9 years. | 10 to 19 years. | 20 years and upwards. | ||||||||||
| Laryngeal Complication. | Sudden. | Exhaustion. | Convulsions. | Laryngeal Complication. | Exhaustion. | Suppressed Urine. | Laryngeal Complication. | Sudden. | Exhaustion. | Laryngeal Complication. | Exhaustion. | Brain Disease. | |
| Class 1 | 14 | 4 | 12 | — | 7 | 4 | 1 | — | — | 2 | 1 | 2 | 1 |
| Class 2 | — | — | — | 1 | — | 1 | — | — | — | — | — | — | — |
| Class 3 | 3 | — | 1 | 1 | — | — | — | 1 | 1 | 1 | 1 | — | — |
| Total | 17 | 4 | 13 | 2 | 7 | 5 | 1 | 1 | 1 | 3 | 2 | 2 | 1 |
27. Relation of Diphtheria to Scarlet Fever. —This is clearly not the proper place
for the discussion of theoretical questions, and I shall therfore address myself merely
to the practical inquiry whether scarlet fever and diphtheria are or are not mutually
protective against each other, as they would be expected to be, if merely phases, as some
suppose, of the same disease. The following facts may be regarded as a contribution
to the solution of this question; and in themselves point to a reply in the negative.
1.° In 7 cases of class I the diphtheritic sore throat was stated to have been
associated with recent scarlet fever. In only 2 of these cases did the rash appear
in the course of the throat affection. Out of the remaining 5 cases in which
the rash appeared first, and the diphtheritic sore throat secondarily to it, the
rash had in 4 cases left the skin before the exudation upon the mucous
membrane made its appearance.
The following represents the proportion of those who had and had not thus suffered.
| Had Scarlatina previously. | Not had Scarlatina previously. | Total. | |
|---|---|---|---|
| Class1 | 9 | 29 | 38 |
| Class2 | 1 | 2 | 3 |
| Class3 | 2 | 4 | 6 |
| Total | 12 | 35 | 47 |
This proportion of 1 to 3 docs not I imagine differ greatly from that which
would be found to exist among persons selected in any other manner from
the same ages, and the same station in life. In the 12 patients who had had
scarlatina, the occurrence of the disease was dated back to periods varying from
6 months to 5 or 6 years. Now it may positively be asserted that of the
cases of scarlet fever that are met with in practice, second attacks of the
disease do not constitute one-third or any proportion approaching this. A
second attack of scarlet fever is indeed so uncommon, that well authenticated
cases are among the rarest occurrences in medical experience.