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186
the mucous membrane of the throat, though it sometimes
attacks other mucous surfaces and even wounds.
That dirt, damp, and insanitary surroundings are
conditions favourable to the propagation of the disease
and its subsequent development, I am inclined to
believe, but that to these must be added the specific
diphtheritic virus.
In my first Report I expressed the opinion regarding
the zymotic diseases that "none of them have any selforiginating
power; they are not generated in the
system by any abnormal processes of nutrition or
secretion ; they are not begotten of dirt, poverty, or
neglect, though these greatly aid their extension;
they are the product of a distinct virus, conveyed
directly or indirectly from one person to another, and
they manifest their potency and individuality by
producing the same diseases in others." To that
opinion I adhere.
The localities in which deaths from this disease
occurred are shewn in Table Va.
In London the rate was 0.32 per 1,000 inhabitants,
the average annual rate during the preceding decennium
having been 0.23.
Whooping Cough caused 82 deaths—67 in St.
Mary's and 15 in St. John's Sub-district—equivalent
to an annual rate of 0.7 per 1,000 inhabitants, as
compared with 0.22 in the preceding year.