Diphtheria / by William P. Northrup ; measles, scarlatina, German measles / by Theodor von Jürgensen ; ed., with additions by William P. Northrup ; authorized translation from the German, under the editorial supervision of Alfred Stengel.

Northrup, William P. (William Percy), 1851-

Date:: 1902

Credit: Diphtheria / by William P. Northrup ; measles, scarlatina, German measles / by Theodor von Jürgensen ; ed., with additions by William P. Northrup ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.

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$ETIOLOGY. cases are untloubtedly a frequent source of infection. The massing together of children in hospitals, institutions, and schools is often the means of spreading the disease not only among these children, but among other groups with which they come in contact. In this con- nection the following, taken from the Bulletin of the New York Board of Health, is of interest: ‘Ht has been the practice of the Department to plot upon a city map the location and data of every case of diphtheria in which the diagnosis has been settled by bacteriologic examination. After several months the map presented a very striking appearance. Wher- ever the densely settled tenements were located, there the marks were very numerous, while in the districts occupied by private residences very few cases were indicated as having occurred. It was also appar- ent that the cases were far less abundant, as a rule, where the tene- ments were in small groups, than in the regions of the city where they covered larger areas. At the end of six months there were square miles in which nearly every block occupied by tenements contained marks indicating the occurrence of one or more cases of diphtheria, and in some blocks many (15 to 25) had occurred. ‘A\s the plotting went on, from time to time the map showed the infection of a new area of the city, and often the subsequent appear- ance of an epidemic. It was interesting to note two varieties of these local epidemics: in one the subsequent cases evidently were from neighborhood infection, while in the second vjwiety the infection was as evidently derived from schools, since a whole school district would suddenly become the seat of scattered cases. At times, in a certain area of the city from which several schools drew their scholars, all the cases of diphtheria would occur (as investigation showed) in families whose children attended one school, the children of the other schools being for a time exempt.’’ Milk.—Reports of epidemics tracealde to infected milk a])pear from time to time; and when we consider that milk is such a favora- ble medium for the growth of the bacilli, and that, too, without any observable change in its appearance, there seems to be good ground for the belief in the occasional occurrence of this method of in- fection. Thus, Kober,* in an anal3^sis of 36 epidemics of diphtheria attributed to the milk-su})pl\, states that in 13 there was evidence that the disease prevailed at the dairv. In these instances the milk was handled while the patients were ill with diphtheria. In 12 there were inflammator} conditions of the teats and udders of the cows. Jour. Med. Sci., May, 1901.$