Dr. Page's report to the Local Government Board on diphtheria prevalence in Berwick-upon-Tweed urban sanitary district / [David Page].

  • Page, David, M.D.
Date:
1888
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Licence: Public Domain Mark

Credit: Dr. Page's report to the Local Government Board on diphtheria prevalence in Berwick-upon-Tweed urban sanitary district / [David Page]. Source: Wellcome Collection.

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    formerly as abundant as diphtheria, has, since 1886, almost disappeared from the death register; the diminution in the total fatality from throat illness having since then been more than replaced by deaths from “ diphtheria.” Table showing the Number of Deaths recorded from Diphtheria and Croup (non-spasmodic) in the Parish of Berwick and Townships of Tweedmouth and Spital in each Year from 1878 to 30th June 1888. Locality. 18 78. 1879. 1880. 1881. 1882. 1883. 1884. 1885. 18SG. 1887. 1888 to J une 30. Diphtheria. Croup. Diphtheria. Croup. • 2 o -M £ s Croup, ■BI.iappplTQ Croup. ci o 4-* 'P 5 Croup. Diphtheria. Croup. Diphtheria. Croup. Diphtheria. P, O U O Diphtheria. d o u O Diphtheria. Croup. Diphtheria, j Croup. Berwick, population 3 3 2 3 1 1 0 2 0 3 2 0 5 o O 1 X 2 4 0 1 0 5 0 9,213. Tweedmouth, population 2 1 0 l 0 0 0 0 1 1 0 2 0 0 4 0 0 2 3 0 8 1 2,885. Spital, population 1,900 i 1 2 0 0 1 0 0 0 1 0 0 0 3 1 0 0 1 6 1 1 0 Total 6 5 4 4 l 2 0 2 1 5 2 2 5 0 6 2 4 3 10 1 14 1 With such a history of endemic diphtheria, it was hopeless to inquire into the origin of the disease, and the chief object of my investigation has been to discover, if possible, the main influences which have been concerned in its persistence and spread, with marked preference, so far as shown by the mortality, for one and another of the three sections of the sanitary district. For this purpose, I sought to learn the amount of sickness from diphtheria and allied ailments which had been noted in the medical practice of the district since the beginning of 1887, to the date of my visit, July 17th, 1888. This was most readily given to me, to the extent of the information at their disposal, by the whole of the medical practitioners, and altogether I received lists of 44 households which had been attacked with diphtheria or similar throat illness during the 18 months preceding my visit. But unfortunately, while I heard in addition of more or less prevalence of “ sorethroat ” and “ mumps ” during the earlier months of the present year, ailments for which diphtheria in its slighter manifestations is shown, by experience, to be somewhat com¬ monly mistaken, such cases as had come under medical treatment had not been completely recorded, and in the sequel, I was unable to acquire any¬ thing more definite from other sources of information. Thus, one medical practitioner told me that although no true diphtheria had come under his care, several cases of “ sorethroat like mumps, but with aphthee on the tonsils,” had, but he was unable to furnish the dates or whereabouts of the families affected. So far as I could procure, from medical evidence, a history of the course of infectious disease over the period in question, it would appear that there was diphtheria in the spring of 1887, followed by an epidemic of measles in summer and autumn, in the latter of which diphtheria again made its appearance, concurrent at first with scarlatina, and continued prevalent as diphtheria until May of this year, when it ceased, and was superseded by the scarlatina of mild type which had been concurrent with it. No notable association of these two diseases, in families, had been observed. In the hope of learning something as to the prevalence and locality of the minor sorethroat referred to among school children, the school attendance lists were examined, but without result; references to scarlatina, mumps, and sorethroat as causes of absence were, indeed, met with, but were admittedly incomplete, and no special incidence of any of these was apparent upon one or another of the elementary schools of the district. In regard to the earlier attacks of true diphtheria during the present year, special inquiry was made as to the incidence of the disease upon school-