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25
Brampton. The deaths from this cause in 1883 were 24, of
which only 4 occurred in the Brompton sub-district. Not all
deaths classified to diphtheria are really caused by this disease;
cases of scarlatina anginosa are sometimes erroneously certified as
diphtheria. On the other hand, it sometimes happens that true
diphtheria is not recognised in the primary stage, and the specific
nature of an apparently simple throat disease does not become
known until paralysis supervenes. Cases of croup, again, are
sometimes described as diphtheria, and vice versa. Diphtheria, it
may be added, does not often show a disposition to become
epidemic,, or even endemic, in the Metropolis. Occasionally,
however, when the disease occurs as a result of insanitary conditions,
it will spread in the family, and instances of this kind
were not wanting in the past year. The following cases may be
cited as of special interest. In one house there were 8
cases (none of them fatal). In the domestic cistern, examination
having been made owing to the unpleasant taste of the water, the
bodies of several kittens were found tied together. In another
house there were 4 cases, all of children. The family occupied two
rooms, but one room being under repair, the four children were
put to sleep in one bed. One of the children had a throat
affection, and the other three caught it. This throat affection
proved to be diphtheria, and two of the children died of it at
St. Mary's Hospital, whither all four of them had been removed. In
another family a first fatal case was mistaken for quinsey: a
second fatal case was certified to be diphtheria. The Asylums
Board, it may be mentioned, do not treat diphtheria in their
hospitals, and difficulty is occasionally found in obtaining means
of isolation for patients who, by reason of the circumstances of the
family, or the occupation of the head of the family, ought to be
removed. One of the deaths occurred in the family of a milkman.
Fever.—The deaths from the three diseases grouped as
"fever" were 30, viz., 18 in the Town sub-district, and 12 in
Brompton; the decennial average, corrected for increase of
population, being 36.