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89
4.—Diphtheria (decennial average 14.2).
The 13 deaths from this disease in 1895 were below
the average, 11 of the deaths were children under five
years, 10 of the 13 belonged to the parish of St. Griles-inthe-Fields.
According to the Registrar-General's Returns
the mortality from diphtheria was considerably greater in
the east group of sanitary areas than in any other, being
0.81 per 1,000 against 0.42 for the central group.
Anti-toxic Serum Treatment of the Disease.—-The following
Report of the Medical Superintendents of the hospitals
of the Metropolitan Asylums Board, issued in March last,
is interesting. It contains the statistics of the cases of
diphtheria treated in 1895, during the whole of which
diphtheria anti-toxic serum was used.
The results obtained in 1895 were distinctly better than in 1894.
The Superintendents state that the improved results as shown by the
statistics and by clinical observations were manifested in the following
respects:—
1.—A great reduction in the mortality of cases brought under treatment
on the first and second day of illness.
2.—The lowering of the combined general mortality to a point below
that of any former year.
3.—The still more remarkable reduction in the mortality of the
laryngeal cases.
4.—The uniform improvement in the results of tracheotomy at each
separate hospital.
5.—The beneficial effect produced on the clinical course of the
disease.
The cases treated in 1894 before the use of anti-toxin numbered 3,042
and the deaths 902, or 29 6 per cent. The cases treated with anti-toxin
in 1895 numbered 2,182, and the deaths 615, or 281 per cent.; but from
these figures must be excluded a large proportion of the less severe
cases, so that to obtain a fair comparison all the cases for 1895 must be
taken, both those treated by anti-toxin (including nearly all the severe
cases) and those not treated by anti-toxin (including most of the less
severe). We then find that the number of cases was 3,529 with 796
deaths, or 22.5 per cent., as compared with a mortality of 29.6 per cent.
in 1894.