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35
One case of infection was imported into the Borough. In
several cases it was very clear that a preceding tonsilitis of several weeks
duration predisposed to an attack of Diphtheria. In 14 cases there
was a history of previous throat trouble frequently recurring. In
two cases the attack was preceded by "sore-throat" in other members of
the family. In one case the infection appears to have been communicated
by a child recently discharged from a Fever Hospital.
The triumphs of the anti-toxin treatment of diphtheria are now
universally recognised, and the results of the treatment in the large
fever hospitals of the metropolis are a striking testimony to its value.
In these hospitals the case-mortality amongst the diphtheria patients,
which in 1893 (the year before the disease was treated with anti-toxin)
was 30.4 per cent., was last year only one-third of that figure. While
doubtless there has been some slight attenuation in the virulence of
diphtheria during recent years, the beneficent effect of the administration
of anti-toxin can alone be responsible for the bulk of this wonderful
improvement in the short space of eleven years.
Amongst the cases treated with Anti-toxin at, the Brook Hospital
at the very onset of symptoms of diphtheria, the mortality for six
recent years was nil. Among those treated on the second day of
onset the mortality was under 5 per cent.; while amongst those in
which the treatment was postponed to the fourth or even later days
from the appearance of marked symptoms, the percentage rose to
about 20. These facts serve to very clearly demonstrate the great
value of an early administration of this curative agent.
Many applications have been made at the office for tubes of antitoxin,
which I store for the convenience of local practitioners.
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 to the medical
practitioners in Stoke Newington continue to be much appreciated.