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45
Diphtheria. This disease is responsible for ten deaths. Last year it was registered
as the cause of nine. Of the ten, four deaths occurred in outlying institutions. The
remarks made in my annual report for 1889 with regard to the accurate diagnosis of
this serious complaint, the necessity for prompt notification, and speedy removal or
isolation, still hold good. I may perhaps be permitted to quote the remarks of one of
the highest authorities in London on sanitation respecting this disease. He says—"I must
remark that Diphtheria is still exceedingly prevalent in London, and seems to be taking
a hold of London and some of our great towns, for reasons that have not yet been
explained. Thus in the 28 largest English towns, including London, the Diphtheria death
rate in 1890 was one-third as high again as the rate for the previous ten years. In
Norwich it was twice as high, in Sheffield more than twice, in Newcastle 2½ times, in
Manchester more than 21 times, in Derby nearly 4 times, in Blackburn 4 times,
and in Salford more than 41 times, as high as in the previous ten years. The increase
was not so great in London, where it was only half as high again as in the previous
ten years."
Erysipelas has caused one death.
Whooping Cough has caused forty-seven deaths. In the year 1889 the number was
twenty-three. In a majority of these cases the poor little patients had been allowed to
suffer from the disease—as being "a disease that every child must have"—for so long
a time without the requisite precautions being adopted, that a fatal termination by
exhaustion and convulsions could not be avoided.
Measles, complicated with different forms of lung disease, has caused thirty-seven
deaths. In 1889 the number of deaths was nineteen; and in 1888 the number was
seventeen.
Diarrhœa, entirely infantile, has caused thirty-three deaths. In 1889 the deaths from
this disease were twenty-four. In 1888 and 1887 they were thirty-seven and forty-four
respectively. With regard to the three last-mentioned forms of zymotic disease which
show so marked an increase when compared with last year, I find that we arc not so