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disease was diagnosed. This circumstance makes it very difficult to
trace infection after such an interval of time, and it is doubtless
responsible for spread of the disease in the early stages of sickness.
DIPHTHERIA.
The 137 cases of Diphtheria occurred in houses, 32 of which were
more or less insanitary. The sanitary defects were grave in 15 and
slight in 17 instances.
School attendance is either alleged by the parents or surmised
by myself, on good grounds, to be the cause of 14 attacks during the
year, and to be responsible for 10.2% of the cases.
Five cases of the infection were imported into the Borough. In
one case it was very clear that a preceding tonsilitis of several weeks
duration predisposed to an attack of Diphtheria. In four cases the
attack was preceded by "sore-throat" in other members of the
family. One case was contracted in a Scarlet Fever Ward of one of
the Hospitals. The infection appears to have been contracted outside
of the Borough in 7 instances.
In many of the cases I was unable to trace the origin of the
disease in any satisfactory manner; that is to say, after carefully
ascertaining all the facts, the origin of the infection could only be
conjectured, and it was impossible to do more.
In this disease the spread of the infection (and by consequence
the mortality) are largely due to the unfortunate circumstance
that the early diagnosis of the disease from clinical symptoms is
frequently difficult and impossible, and Bacteriology alone can solve
the difficulty in many cases. The Diagnosis outfits provided by the
Council during the year to the medical practitioners in Stoke
Newington continue to be much appreciated. Every practitioner has
been kept supplied with such an outfit, and has thus had at his
disposal the means of procuring a bacteriological diagnosis of both
Diphtheria and Typhoid Fever The following is a list of the
applications received, together with the results of a careful examination
performed at the Jenner Institute of Preventive Medicine, London.