Mr. W. H. Power's report to the local government board on diphtheria at Hern Hill, in the Faversham rural sanitary district ; on the sanitary state of that district ; and on administration by the rural sanitary district.

  • Power, W. H.
Date:
1880
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Licence: Public Domain Mark

Credit: Mr. W. H. Power's report to the local government board on diphtheria at Hern Hill, in the Faversham rural sanitary district ; on the sanitary state of that district ; and on administration by the rural sanitary district. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    disease germs, the populations of towns and sandy tracts should enjoy so much immu- nity as they do. On the other hand, suppose the infective organism is capable of thriving outside the human body, its external habit might be parasitic in some lower animal, or vegetable, alive or dead, or on the earth, or in water, or in air. As to the first, it has not been noticed, as far as I am aware, that diphtheria usually occurs in relation to the presence of any particular animal, still less to any particular disease of any particular animal. If such relation does hold, the animal must be very minute, for inquiry concerning the larger animals acquits them of any habitual share in the process of infection. The supposition that diphtheria, in the origin of an outbreak, is caused by an organism that haunts air, or water, appears to me to conform most closely to the requirements of observed fact. It is quite reasonable to suppose that such an organism, having a subsistence dependent upon seasonal conditions, should have its own special season of maximum growth and reproductive power; that it should be capable of infecting water or milk; and that it should affect preferentially a particular character of soil, such as clay, and avoid the smoky purlieus of a town. The preference of diphtheria for dwellings in exposed and elevated situations is difficult to explain on any theory, except that of exposure to the wind and to whatever the wind may carry. (Tor valuable arguments and suggestions in support of this theory I would refer to Mr. A. Wynter Blyth’s paper cited above.) Such facts as that of the immunity of town children attending a country school, could be understood, if we suppose that the country children, taking another direction, breathed air containing an organism which the tovcn children escaped. Possibly, the “progressive development of infectiveness” observed by Dr. Thorne at Llanrhaiadr, might correspond (as Dr. Thorne has himself suggested *), to progressive development of the organism tovcards the attainment of full reproductive power. Such an organism might be expected finally to yield itself to microscopic identifica- tion in its (supposed) native haunts. MIDHUEST. [Registeak-Geneeal’s Quaeteety Retuen, 1879, Fourth quarter.—District, Midhurst; Sub-district, Fernhurst. Four deaths from diphtheria. (Registrar’s note, “ The “ four deaths from diphtheria occurred in the parish of Lurgashall.”)] 1. The district of Midhurst in the West of Sussex and especially this sub-district of Fernhurst, which lies on the Wealden Clay, is one which is habitually visited by diph- theria. Year after year, in one village or another, along a certain tract of clayey, wooded, wet country, the Medical Officer of Health has had his attention called to isolated outbreaks of diphtheria. 2. The neighbouring villages of Lurgashall and North Chapel have been among those most frequently visited by this disease. There was an outbreak of diphtheria at North Chapel, two miles from Lurgashall, in 1878. Possibly from the survival of the contagium derived from North Chapel (for there is communication between the two villages), or possibly from the revival of dormant contagium derived from former attacks of diph- theria in Lurgashall itself; diphtheria (or at least severe sore throat of a contagious nature) appeared anew near the latter village in June 1879, in the family of a copse cutter, named Kingshott. The children first attacked were a brother and sister, aged 10 and 13, who were attending Lurgashall school. Subsequently two older brothers and also the father and mother were attacked. All recovered. This family lived in a lonely cottage, a mile distant from the village. There was no suspicion of recent diphtheria at the school which the children attended; nor was there anything in the surroundings of the house of a specially unwholesome character,—nothing beyond the general wetness of tliis part of the country. 3. No other cas*-s were recognised or remembered imtil October, when the disease broke out afresh among children attending Lurgashall school. This recrudescence of the infection first showed itself in a family of six children ; of whom three, who at- tended the school, were first attacked, and then two younger ones, while the parents and eldest son (17) escaped. All recovered. They lived at the edge of a clayey waste, called Windfold Wood Common. Two other families in the same locality w^ere soon * “ Keinarke on the origin cf Infection,” The Practitioner, vol. xx., No. vii., June 1878, p. 480.