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19
ending in only 10 cases. One hundred and sixty-five
cases were removed to the Isolation Hospital.
Diphtheria.
During the year 150 cases of Diphtheria came under
the notice of the Sanitary Authority. Of this number
124 were removed to the Hospital, and the remainder,
viz., 26, were nursed at home. Of the number removed
to the Hospital, 16 died, giving a death rate of 12.9 per
100 cases; of those remaining at home 2 died, giving a
death rate of 7.6 per 100 cases.
Mitcham, as might be expected with its larger and
poorer class population, was responsible for no less than
108 cases, Beddington coming next with 19 cases. It
may be fairly assumed that schools influence very
materially the incidence of the disease. More particularly
is this influence felt when the epidemic of Diphtheria is
not of a very severe type, and this is frequently noticed
at the commencement of an epidemic. It should be
remembered that for practical purposes cases of
Diphtheria may be divided into two classes, viz.,
Clinical Diphtheria, in which all the symptoms of true
Diphtheria are found at once in the patient, and the
patient can at once be segregated, and all infection by
direct contact be avoided for persons who are not
immune to Diphtheria. These cases offer but little
trouble to the Sanitary Authority, as all necessary steps
can be at once taken to prevent any further spread. But
it is to the second class of case, viz., the Bacteriological
Diphtheria, in which the symptoms are so vague and so
indeterminate that the true diagnosis of the disease can
only be arrived at by bacteriological examination, that
is the source of most outbreaks. Now, in a certain