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Diphtheria—Proportion of cases in hospitals.
It will be seen on reference to diagram X. that there was in 1901 a slight decrease in
the proportion of the notified cases of diphtheria admitted to the hospitals of the Metropolitan
Asylums Board compared with the proportion in the preceding year. In the report of the
Statisticail Committee of the Metropolitan Asylums Board for 1901 it is pointed out that the
proportion of diphtheria admissions to notifications has risen from 17.87 in 1890 to 74'85 in
1901, and that the low figures of 1893 were due to the fact that scarlet fever and diphtheria
were unusually prevalent in that year and the Board's hospital accommodation quite inadequate.
" Return cases " of diphtheria.
" Return cases " are mentioned in a few of the reports, and particulars are given by the
medical officer of health of Wandsworth of three cases resulting in one instance, and eight cases
resulting in another from exposure to a child who had been discharged from hospital where it
had been admitted on account of suffering from diphtheria.
Bacteriological examination of material from suspected cases of diphtheria.
In Westminster it was decided to extend to the whole city the arrangements which
previously existed in some of the constituent districts for the bacteriological examination at
the Jenner Institute of material from the throats of persons suspected to be suffering from
diphtheria. Of 52 specimens thus examined, in 16 the bacillus was found, in 34 it was not
found and in 2 the pseudo-diphtheria bacillus was found. In St. Pancras, where similar
examination is made, in 99 cases the bacillus was found, in 144 it was not found and in 3 it
was doubtful. In Islington 170 specimens were examined, 80 of which " resulted in a positive
diagnosis of the disease." In Stoke Newington 28 specimens were examined at the Jenner
Institute, in 12 of which the bacillus was found, in 13 it was not found and in 3 the pseudodiphtheria
bacillus was found. In Hackney, in 35 instances material was sent to the Jenner
Institute for examination. In Finsbury, material from 98 cases was examined, the results
being that the diphtheria bacillus was found in 29 cases, the pseudo-diphtheria bacillus in
7 cases, the results being negative in 62 cases. In Poplar, material was sent to the Jenner
Institute in 84 instances. The diphtheria bacillus was isolated in 36 and the pseudo-diphtheria
bacillus in 7 instances. At the end of the year a laboratory was provided in Bermondsey for
the examination of pathological matter. In Lambeth, 233 samples were examined, the KlebsLceffter
bacillus being found in 48 and the pseudo-bacillus in 1 sample. In Deptford arrangements
were made with the Clinical Research Association for the examination of material, and
every medical practitioner supplied with the necessary apparatus for sending it for examination.
In Aloolwich, material from 26 cases was sent to the Jenner Institute. The diphtheria bacillus
was isolated in 6 cases and the pseudo-diphtheria bacillus in 1 case.
Supply of antitoxin.
In Stoke Newington many applications were made to the medical officer of health
for antitoxin, which he stores for the convenience of local practitioners. In Hackney
30 bottles of antitoxin were supplied by the medical officer of health. In Finsbury
arrangements have been made for the supply to medical men free of charge of one dose of
antitoxin for each notification received, and also doses of antitoxin to any medical practitioner
who desires to use it for prophylactic purposes. In Lambeth antitoxin is distributed gratuitously
as a remedy and a prophylactic, and during 1901 75 vials were thus distributed. In Greenwich
66,000 units were distributed.
Diplitheria—Age and sex distribution.
The following table shows the cases, deaths, case rates, death rates and fatality of diphtheria
at the several ages, and for each sex in London during the year 1901. As in preceding years
the incidence of attack at " all ages" was greater on females than on males, but the death rate
and fatality were higher among males than among females. In the age groups adopted for the
purposes of this table the greatest incidence of attack was upon males and females of four years