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37
DIPHTHERIA.
The 53 cases of Diphtheria occured in 47 different houses; and
in only 4 instances were sanitary defects of a grave nature found to
exist in the home of the patient. In all probability 4 of the cases
resulted from such insanitary conditions in the homes of the patients
as gave rise to the escape of offensive odours. Thus 7.5 per cent. of
the total cases arose from this cause, as against 19.7 percent. in the
preceding year.
School attendance is either alleged by the parents or surmised
by myself, on good grounds, to be the cause of 4 attacks during the
year, and to be responsible for 7.5 per cent. of the cases as against
12.7 per cent. in the preceding year.
Three cases of the infection were imported into the Parish. In two
cases it was very clear that a preceding tonsilitis of several weeks'
duration predisposed to an attack of Diphtheria. Two unhealthy
cats were destroyed, but a bacterial examination of their throats
failed to detect the germ of Diphtheria.
In as many as 39 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.
It is discomforting that the increase in the death-rate from
Diphtheria cannot be checked. As a matter in Preventive Medicine
it is the question of the day, and its great importance demands the
adoption of further measures of coping against the origin and spread
of this disease.
In this disease the spread of the infection (and by consequence
the mortality) are largely concerned with the unfortunate circumstance
that the early diagnosis of the disease from clinical symptoms
is frequently difficulty and impossible, and it is therefore highly
desirable that every Sanitary Authority should contrive to make such
arrangements as would provide practitioners with the promptest
possible answer to the problems—Is this a case of Diphtheria?
Bacteriology alone can furnish the answer in many cases, and every