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31
assumption of diminished malignancy in the type of the disease,
and more probably due to the inclusion among the hometreated
cases notified, of a considerable number of cases of nonspecific
throat disease. One could not but feel this to be a
reasonable explanation of an otherwise puzzling fact, when, as in
September, a whole month passed without a death, although
twenty-two cases were notified. In my tenth monthly report
(October 6th, page 102), at the conclusion of the fortieth week, I
called attention to the subject, and to the diminishing death-rate
from the disease. At that date twenty-Fix deaths had been
registered: the recorded cases were one hundred and fifty-seven, and
the percentage mortality 16.6. But in the first half period, the
cases having been seventy-five only, the deaths were sixteen, or
21'S per cent., whilst in the second half period, ten only out of
eighty-two cases proved fatal = 12.2 per cent. Of the eighty-two
cases, fifty-two were recorded in the twelve weeks ended October
4th, and only three deaths were regis tered, or less than 6 per
cent.* In the last four weeks, as. above stated, there were
twenty-two cases and no deaths. "It is to be presumed, therefore,"
I remarked, "that the epidemic, so far at least as this
Parish is concerned, is losi ng some of its virulence. That many
of the cases are extremel y mild is evidenced by the fact that in
some instances when infected houses have been visited immediately
oil report of the iJ iness, the patients have been found up and
about, and in more tham one instance not at home ! It is almost
impossible, however, to resist the conclusion that innocent throat
troubles have been sometimes mistaken for diphtheria," and
considerable su bsequent experience, reaching down to the present
writing, has but strengthened this view. Twenty out of the twentytwo
cases above referred to occurred in North Kensington ; only
two were remov ed to hospital, and there was no extension of the
disease from the cases treated at home, notwithstanding the
* In my eleventh report, dated November 3rd, I reported that forty cases
had occurred in. the previous eight weeks, and only one death had been
registered. This fact is the more noteworthy, seeing that the disease was very
prevalent and very fatal in the Metropolis, the weekly numbers of deaths being
the highest ever recorded.— Vide Registrar-General's Weekly Returns,