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entirely free from the disease, this, of course following from a belief
in the benign nature of the disease. This epidemic deserves being
recorded, because it illustrates in the first place one of the modes in
which. Diphtheria is spread, that is, amongst school children at school
ages. Secondly, it is an instance of definite cases of Diphtheria
being preceded by a series of sore throats or tonsillitis, not presenting
any specific characters, and having a duration of three or
four days only, an apparent instance of what has been aptly described
as "a progressive development of the property of infectiveness."
Thirdly, it shows the value of the preventive measures
adopted, isolation, quarantine, etc., in checking the spread of the
disease, for fresh cases ceased to develop at the end of about a
week after their adoption. Fourthly, it is of interest as being the
first instance in which the help of bacteriology has been sought by
the local authority of Hackney, in order to establish a diagnosis to
prepare the way for the adoption of preventive measures.
From the experience of this epidemic, I am disposed to regard
every case of sore-throat or tonsillitis, occurring in an institution of
young people, with grave suspicion. That it may be the forerunner
of a series of cases ending in Diphtheria is at least possible,
and the only logical deduction is to regard all sore throats in such
institutions as infectious, and to recommend their isolation. I
think if this were rigidly carried out in schools and similar places,
a considerable diminution in the prevalence of Diphtheria would
result.
Enteric or Typhoid Fever.—The notifications for this disease
during 1895 show a large increase upon those for 1894, no less than
256 cases being reported. These are equivalent to an attack rate
of nearly 1.2 per 1,000 living persons. The deaths numbered 45,
giving a death rate of .21 per 1,000. The death rate for all London
for the year was .14 per 1,000.