View report page

9
some reference to an ENDEMIC OF SORE THROAT, which
commenced at the middle of August, attained its height in September,
and continued more or less to the end of the year.* The disease
usually set in with shivering, headache, prostration, heat, quick pulse,
malaise—the general symptoms of febrile disorders. The tonsils
were found tumid, and the throat generally red and swollen from
sub-mucous infiltration, with external swelling and tenderness
oftened confined to one side, usually affecting the cervical glands,
and, but rarely, the parotid. In the latter case the swelling was
of stony hardness, and occasionally ended in abscess. In delicate
strumous persons the tonsil now and then suppurated, but very
slowly. There was an abundant glairy or frothy secretion clogging
the fauces and producing a sense of suffocation in the recumbent
position. There was much sharp pain also, especially in deglutition
—which occurred often involuntarily, adding much to the distress,
and excited by the secretion. Occasionally, it may be added, there
was a slight measley rash, and an exudation on the tonsils not unlike
Diphtheria. The tongue, however, was not that of Scarlatina,
and there was no cuticular desquamation. Sometimes the appearance
was that of follicular tonsillitis. In many cases the urine
was albuminous, always scanty, and occasionally bloody. Robust
people were often attacked, and several members of a family
almost simultaneously, while in other instances the cases would
occur in such a succession as to suggest infection as the origin of
the latter cases, and this was especially so in cases resembling
follicular tonsillitis. The disease was of an eminently asthenic
type, suggestive of blood poisoning, and not seldom associated
with Erysipelas. More ordinary throat affections were rife
at the time. The disease often ran its course in from three to
seven days, sometimes terminating rather suddenly. In suppurative
cases the duration was longer—with prolonged debility, tardy
convalescence, especially from the glandular enlargements.
Relapses were not unknown. Some practitioners thought they
had seen the disease before, but to many it presented features
quite new to them. The principal sufferers were well-to-do
people living near open spaces—large gardens, squares, the
parks, and on a gravelly soil: the poor inhabitants of close,
densely packed localities, and on clay oil, suffered little. The
malady was not confined to Kensington. Among other places,
Chiswick and Twickenham suffered severely, while Richmond
escaped. By some the disease was ascribcd to ordinary malaria,
and by others to sewer smells from open drains, or to a depressing
influence of the air. Soothing remedies, suitable in cases of
Quinsey, were useless; the disease called for tonics, stimulating
gargles, ice, wine, and nourishing food. So far as I can ascertain,
*For many of the facts in connection with this endemic, I am indebted to Dr. Pearson,
of Kensington, who read a paper on the subject at the Medical Society of London.