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12
During the year there were registered in St. Pancras no deaths from either
small-pox or typhus fever, and only one death from continued fever, from enteric
fever 22, and from scarlet fever 27 deaths. The number of deaths from each of the
principal zymotic diseases was below the average during the year, with the
notable exception of diphtheria, which in gross number of deaths ranks with the
more common children's diseases, namely, measles, whooping cough, and diarrhoea.
Diphtheria.—The number of deaths from Diphtheria and Membranous Croup
in 1888 was 72, in 1889 was 62, and in 1890 increased to 141. This increase
was coincident with the commencement of the operations of the Infectious Diseases
(Notification) Act at the end of October, 1889. The increase has been not only
in the number of notified cases, as might be expected, but also in the number of
deaths registered, reference to the tables appended will show the number of deaths
occurring monthly throughout the last three years. It is evident that there is
some connection between Notification and the increase of mortality from diphtheria
and membranous croup. It is possible that a proportion of deaths formerly
certified as due to tonsillitis, sore throat or quinsey, possibly also to croup and
laryngitis, may now be certified as due to diphtheria. It is also possible that
deaths from scarlatinal sore throat may be similarly certified. The reason for the
deaths being so certified might in a measure be attributable to the fact that the
diseases causing the deaths had already been so certified to the Medical Officer of
Health under the Infectious Diseases (Notification) Act.
Although the number of deaths from diphtheria are annually increasing in
the Metropolis, the sudden accession to the number in St. Pancras, is incomprehensible
unless it be assumed that it is highly probable that some variation in
diagnosis or nomenclature is the cause of part of the increase at least. Disinfection
has been most fully and most carefully carried out in all cases during the
period and the complete process of fumigation of interiors, disinfection of clothing
bedding, &c., by high pressure steam, and stripping and cleansing of walls,
ceilings and floors carried through. Isolation has been equally carefully increased,
during 1888 no cases of diphtheria were received into the Metropolitan Asylum
Board's Hospitals, in 1889 St. Pancras sent 6, which number in 1890 was
increased to 94.
Notification does not appear to have had a corresponding effect upon the
number of deaths from any of the other diseases notifiable. Compare the tables
for the three years 1888, 1889 and 1890, which follow.
Reference to tables 8B and C in the appendix points to Camden Town as
being the central focus of the disease.