the increase of diphtheria mortality in london

1
1085 m Orion, and other stellar photographs. At ten o’clock there was an effective exhibition of specimens of inverte- brata prepared as lantern slides, dependent on the fact that soft-bodied animals may be dried so as not to contract irregularly, and show like a drawing projected on the plane of glass. In some cases the natural colour is retained. In others artificial staining is used, and brings out very clearly anatomical structure. - COMPLIMENTARY DINNER TO SURGEON PARKE, A.M.S. IT is proposed to invite Surgeon Parke to a compli- mentary dinner to be given by members of the medical profession. A large number of leading metropolitan phy- sicians and surgeons, including Sir James Paget, Sir Andrew Clark, Mr. Jonathan Hutchinson, Professor Marshall, Mr. Erichsen, Sir W. Mac Cormac, Dr. Quain, Sir Joseph Lister, Sir Trevor Lawrence, Sir Prescott Hewett, Mr. Henry Power, Dr. Russell Reynolds, Mr. Alfred Willett, and Dr. B. W. Richardson have signified their willing- ness to become members of a committee to make the necessary arrangements for the purpose. Mr. Howard Marsh, 30, Bruton-street, is acting as honorary secretary, and will receive the names of any members of the profession who are desirous of joining the executive committee or of attending the dinner, which will take place probably about the first week in June. ___ SMALL-POX IN CALCUTTA. THE perusal of an interesting paper in the Indian Aledical Gazette by Dr. Kailas Chunder Bose on the pre- valence of small-pox in Calcutta, and how to arrest its spread, does not give the satisfactory impression that was produced by Sir J. Gorst’s recent reply to Mr. Leng on this subject. In some quarters of Calcutta, at least, the disease has been painfully prevalent. Dr. Bose says that it began in the early winter, and in some districts, as in Burrabazar, every third house is affected. The habits of the people favour- greatly the spread of the disease. All il the members of the affected family sit together in the sick room, and they never change their clothes so long as the patient continues confined to bed, and do not then disinfect them. In many houses there were several cases, and in one eight little children were attacked, and of these three died. Like European physicians, Dr. Bose finds that vaccina- tion pre-eminently is the thing to be enforced for the safetyof the citizens. He has never seen a single case where small-pox occurred after revaccination. The prejudices of the natives, religious and otherwise, however, are great, and in the up- country districts scoundrels go about the districts fraudu- lently -"pretending to be public vaceinators, and inflict wounds on the children and extort taxes from them on this account. Dr. Bose’s paper is worthy of the attention of the sanitary authorities of Calcutta, none the less so that lie is perfectly candid in his discussion of the whole subject. THE HEALTH OFFICERSHIP OF HASTINGS. THE post of medical officer of health for Hastings being vacant, the medical profession, speaking through its medical society, has forwarded to the Town Council a resolution strongly advocating the election of an officer who shall be debarred from private practice and who shall give his whole time to sanitary work. On Tuesday last a meeting of ratepayers was held in furtherance of the same views. It is contended that, with a population of over 50,000, and in so important a health resort, such a provi- sion is highly desirable. The population of the borough has extended largely within the last decade, and con- (,inues to increase. The work of a medical officer of bealth must necessarily increase in larger proportion with the adoption of the Act for the Notification of Infectious Diseases, and with the greater vigilance required now that attention has been called to the dangers of diseased meat and milk-supply. Inconvenience has been felt from the fact that the limits of the borough are not coterminous with the watershed area. The cobs of the hills surrounding Hastings lie in two adjoining rural districts. Could arrange- ments be made for combining tbf districts under one health officer an important step would be gained. In little more than a year’s time the new Act (1888) will come into force, which requires that every town of the dimensions of Hastings shall require in its health officer special know- ledge, guaranteed by the possession of a diploma in Public Health, or otherwise. Surely an important health resort like Hastings should look upon this progressive reform as already in force. The alternative appointment open to the council is that of some local practitioner, who may perhaps have but little experience in public health matters. Again, the aspirant for success in private work cannot be expected to take so independent a line as the man who has no private calls, whilst the relations of the latter with his medical brethren would be more free and unrestrained. The crucial question in making the appoint- ment is likely to be one of salary. If the post is of the importance attached to it by some sanitary authorities, surely the Hastings County Council would do well to show a wise liberality. Blackpool, with 14,000 people, secures the whole time of its officer for the exceptionally small sum of 9250. Guisborough combined district, including Salt- burn and Redcar, with 50,000, does the same for £350. Brighton gives JE500. For a competent officer for Hastings, who would devote the whole of his time to the duties of his office, it will be requisite to make a reasonable advance on the present ;f125 a year. - THE INCREASE OF DIPHTHERIA MORTALITY IN LONDON. THE Registrar-General, in his Annual Summary for London and other large towns in 1889, calls especial atten- tion to the fact that diphtheria mortality in London "had been increasing steadily for many years, but in the last two years (1888 and 1889) had made the most alarming bounds." The deaths referred to this disease within the metropolitan registration area were 953 in 1887, 1311 in 1888, and further rose to 1588 in 1889 ; the latter number exceeding by no fewer than 65G the corrected average number in the preceding ten years. The death-rate in London from diph- theria last year was equal to 0’37 per 1000 estimated to be living, and among the twenty-eight large English towns specially dealt with in the Registrar-General’s returns was only exceeded in Manchester, Salford, and Plymouth. The mean death-rate from this disease in England and Wales last year was 0’19; it was 0-26 in the twenty-eight largest towns, 0’13 in fifty other large town districts, and 0’16 in England and Wales, exclusive of the seventy-eight large towns. Speaking generally, diphtheria has shown a marked increase of mortality in large urban aggregations in recent years, and can no longer be regarded, as formerly, as specially a disease of rural districts. Referring to London, the steady increase of diphtheria mortality during the last three years has been very marked in the following sanitary areas :-Kensington, Hackney, Bethnal Green, Stepney, Mile End Old Town, Poplar, Newington, and Lambeth. It remains to be seen whether this increase will be checked by the arrangements which have been made by the Metro- politan Asylums Board for the isolation of cases of this disease in their hospitals. It appears that 763 cases were admitted to those hospitals during last year, of which 271 terminated fatally, giving a case-mortality of nearly 40 per cent

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Page 1: THE INCREASE OF DIPHTHERIA MORTALITY IN LONDON

1085

m Orion, and other stellar photographs. At ten o’clockthere was an effective exhibition of specimens of inverte-brata prepared as lantern slides, dependent on the fact thatsoft-bodied animals may be dried so as not to contract

irregularly, and show like a drawing projected on the planeof glass. In some cases the natural colour is retained. In

others artificial staining is used, and brings out very clearlyanatomical structure.

-

COMPLIMENTARY DINNER TOSURGEON PARKE, A.M.S.

IT is proposed to invite Surgeon Parke to a compli-mentary dinner to be given by members of the medicalprofession. A large number of leading metropolitan phy-sicians and surgeons, including Sir James Paget, Sir AndrewClark, Mr. Jonathan Hutchinson, Professor Marshall, Mr.Erichsen, Sir W. Mac Cormac, Dr. Quain, Sir JosephLister, Sir Trevor Lawrence, Sir Prescott Hewett, Mr.Henry Power, Dr. Russell Reynolds, Mr. Alfred Willett,and Dr. B. W. Richardson have signified their willing-ness to become members of a committee to make the

necessary arrangements for the purpose. Mr. Howard

Marsh, 30, Bruton-street, is acting as honorary secretary,and will receive the names of any members of the professionwho are desirous of joining the executive committee orof attending the dinner, which will take place probably aboutthe first week in June.

___

SMALL-POX IN CALCUTTA.

THE perusal of an interesting paper in the IndianAledical Gazette by Dr. Kailas Chunder Bose on the pre-valence of small-pox in Calcutta, and how to arrest its

spread, does not give the satisfactory impression that wasproduced by Sir J. Gorst’s recent reply to Mr. Leng on thissubject. In some quarters of Calcutta, at least, thedisease has been painfully prevalent. Dr. Bose says thatit began in the early winter, and in some districts, as inBurrabazar, every third house is affected. The habits ofthe people favour- greatly the spread of the disease. All ilthe members of the affected family sit together in the sickroom, and they never change their clothes so long as thepatient continues confined to bed, and do not then disinfectthem. In many houses there were several cases, and inone eight little children were attacked, and of these threedied. Like European physicians, Dr. Bose finds that vaccina-tion pre-eminently is the thing to be enforced for the safetyofthe citizens. He has never seen a single case where small-poxoccurred after revaccination. The prejudices of the natives,religious and otherwise, however, are great, and in the up-country districts scoundrels go about the districts fraudu-lently -"pretending to be public vaceinators, and inflictwounds on the children and extort taxes from them on thisaccount. Dr. Bose’s paper is worthy of the attention of thesanitary authorities of Calcutta, none the less so that lie isperfectly candid in his discussion of the whole subject.

THE HEALTH OFFICERSHIP OF HASTINGS.

THE post of medical officer of health for Hastings beingvacant, the medical profession, speaking through its medicalsociety, has forwarded to the Town Council a resolutionstrongly advocating the election of an officer who shall bedebarred from private practice and who shall give hiswhole time to sanitary work. On Tuesday last a meetingof ratepayers was held in furtherance of the same views.It is contended that, with a population of over 50,000,and in so important a health resort, such a provi-sion is highly desirable. The population of the boroughhas extended largely within the last decade, and con-(,inues to increase. The work of a medical officer ofbealth must necessarily increase in larger proportion with

the adoption of the Act for the Notification of InfectiousDiseases, and with the greater vigilance required now thatattention has been called to the dangers of diseased meatand milk-supply. Inconvenience has been felt from thefact that the limits of the borough are not coterminouswith the watershed area. The cobs of the hills surroundingHastings lie in two adjoining rural districts. Could arrange-ments be made for combining tbf districts under onehealth officer an important step would be gained. In littlemore than a year’s time the new Act (1888) will come intoforce, which requires that every town of the dimensionsof Hastings shall require in its health officer special know-ledge, guaranteed by the possession of a diploma in PublicHealth, or otherwise. Surely an important health resortlike Hastings should look upon this progressive reform asalready in force. The alternative appointment open tothe council is that of some local practitioner, who mayperhaps have but little experience in public health matters.Again, the aspirant for success in private work cannotbe expected to take so independent a line as the manwho has no private calls, whilst the relations of thelatter with his medical brethren would be more free andunrestrained. The crucial question in making the appoint-ment is likely to be one of salary. If the post is of the

importance attached to it by some sanitary authorities,surely the Hastings County Council would do well to showa wise liberality. Blackpool, with 14,000 people, securesthe whole time of its officer for the exceptionally small sumof 9250. Guisborough combined district, including Salt-burn and Redcar, with 50,000, does the same for £350.

Brighton gives JE500. For a competent officer for Hastings,who would devote the whole of his time to the duties of his

office, it will be requisite to make a reasonable advance onthe present ;f125 a year. -

THE INCREASE OF DIPHTHERIA MORTALITYIN LONDON.

THE Registrar-General, in his Annual Summary forLondon and other large towns in 1889, calls especial atten-tion to the fact that diphtheria mortality in London "hadbeen increasing steadily for many years, but in the last twoyears (1888 and 1889) had made the most alarming bounds."The deaths referred to this disease within the metropolitanregistration area were 953 in 1887, 1311 in 1888, andfurther rose to 1588 in 1889 ; the latter number exceedingby no fewer than 65G the corrected average number in thepreceding ten years. The death-rate in London from diph-theria last year was equal to 0’37 per 1000 estimated to beliving, and among the twenty-eight large English townsspecially dealt with in the Registrar-General’s returns wasonly exceeded in Manchester, Salford, and Plymouth. Themean death-rate from this disease in England and Waleslast year was 0’19; it was 0-26 in the twenty-eight largesttowns, 0’13 in fifty other large town districts, and 0’16 inEngland and Wales, exclusive of the seventy-eight largetowns. Speaking generally, diphtheria has shown a markedincrease of mortality in large urban aggregations in recentyears, and can no longer be regarded, as formerly, as

specially a disease of rural districts. Referring to London,the steady increase of diphtheria mortality during the lastthree years has been very marked in the following sanitaryareas :-Kensington, Hackney, Bethnal Green, Stepney,Mile End Old Town, Poplar, Newington, and Lambeth.It remains to be seen whether this increase will be checked

by the arrangements which have been made by the Metro-politan Asylums Board for the isolation of cases of thisdisease in their hospitals. It appears that 763 cases wereadmitted to those hospitals during last year, of which 271terminated fatally, giving a case-mortality of nearly 40 percent