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15
In a third instance, two children in one family had scarlet fever, but
the mother was clearly ignorant of the nature of their illness, until
her attention was called some weeks later to the peeling of the skin
of the feet. A medical man had seen one of the children on two
occasions, and there being apparently no eruption then existent, the
nature of the case was overlooked, and would never perhaps have been
suspected but for the fact that a man living in the same house, and
who was observed to be ill, was found to have the skin of his hands
peeling while following his daily occupation of a porter, handling and
delivering small parcels of clothing. This man had slept with one
of the sick children, and he was to have been married on the day
following that on which I sent him to the hospital.
I have narrated these histories believing them to be typical of unsuspected
ways in which infectious disease gets spread, and that if
we could trace all outbreaks to their origin, such a case would be made
out as would fairly startle the public mind, and help to get rid of the
too common notion that infectious diseases being "in the air," it
is useless to take precautions against the spread of them:—the
fact being that the "area of infection" is very limited, the victims
having been brought within that area sometimes through sheer wilfulness,
sometimes through indifference, and sometimes through ignorance.
Now and then the conveyance of infection is effected by the "sick"
person himself, who being allowed to mix with healthy, but susceptible,
individuals, mostly children, becomes a migratory centre from which
disease spreads; and there can be little doubt that in the circumstances
of our poor, living as they do in crowded and unventilated rooms,
clothing, e.g. of parents and unaffected children, exposed by day
and night to infection, becomes a means of spreading disease in schools,
workshops, &c.
Diphtheria,—The deaths registered from diphtheria were 26 (males
12 and females 14), and all but one occurred in the Town sub-district.
This is the only zymotic disease of which the fatality was in
excess of the corrected decennial average: the deaths in the previous
year also (20) were above the average. The particulars of investigated
cases almost compel doubts, occasionally, whether some of the
deaths attributed to diphtheria may not really have been due to simple
cynanche, &c.? It has seemed to me that since the end of 1878