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57
DIPHTHERIA.
Diphtheria, unrecognized in England before the year 1859,
is said to have been introduced from France. Its appearance
in London was immediately followed by an epidemic of
considerable proportions. Since then the disease has remained
amongst us, exhibiting itself in local outbreaks of
greater or less severity. Year by year with few exceptions
the attacks have become more numerous. Since 1877, when
316 cases were recorded, the death rate has increased fourfold.
To diphtheria in London alone, during 1888, 1301
deaths are attributable.
About the causal agent of diphtheria, its nature, and its
origin, little is known. The weak and the robust are alike
subject to attack. It affects the well fed equally with the
ill fed. The crowded tenement is not more often the scene
of an outbreak than the villa residence. It occurs in its
greatest frequency and severity among children and during
the first six years of life.
But age does not confer exemption from its influence.
Not unseldom when it makes an appearance in the family,
several or perhaps the whole household are simultaneously
attacked, a circumstance lending weight to the presumption
that the disease manifest in the individual members is
derived from a common origin. Milk, water, and food, have
been variously suspected as the carriers of contagion, and in
many well authenticated instances the suspicion has not
been without foundation.
That the disease is conveyed by contagion from one to
another is a matter of common knowledge, and there is
reason to believe the infectious material clings to the patient