, 1888-03-31
D~IPHTHERIA'S HAVOC.
REPORT OF THE NEW YORK STATE
BOARD OF HEALTH.

Important Facts Regarding tho Prev
alence of a Dreaded scourge-sugges-
lions of Vital Interest to Everybody.
Neo ssIty of OBSERVATION-DISCLOSURES.
The annual report OF the state board of
health presents some important facts re-
Rarding the prevalence of diphtheria-the
most important of the Zymotic diseases.
Probably few persons are aware of the ex-
tent of the havoc worked by this scourge.
For three years past almost exactly one-
third of all the mortality from contagious
iseases has been due to 1t, and during the
past year the percentage showed a slight
incr ease. During the winter months it
sometimes reaches nearly one-half the
mortality under this head. The total
number of deaths from diphtheria has
been increasing during the past three
years, being 1900 out of 80, 400 in 1886,
6, 900 out of SO, 800 in 1886, and during the
twelve months ending Dec. /, 1887, 6,271
out of SO, 500.
ITS DEsTRUCTIvENEss.
1t is more destructive than diarrhea1
diseases, which, in summer, cause two
thirds of the deaths from zymotic dis
eases. 1t was especially prevalent during
last autumn, causing 49, per cent. OF the
deaths from zymotic diseases, but did not
reach the grim average of the preceding
winter, when 1t caused no less than 47.6
per cent. of such deaths. Practically the
same state of things exists in northern
states generally, and in the northern
countries of Europe.
Investigations are steadily in progress
in all countries SO afflicted, as to the
causes of the disease and the possibility
of restricting it. These all point to the
general fact hat the persistence of the
disease is due to the presence of
filth in some form. Epidemics In
villages and small towns, where the
sanitary conditions are more easily deter
mined tina in the large cities, have
demonstrated this so often that it hardly
needs to be proved. Anything which
poisons air or water may be set down as
n cause of diphtheria, and recent cases
have even brought milk within the cate
CORY of the agents of contagion. Lack of
drainage, and the contamination Of wells
n cellars by leaking cesspools, are
among the most obvious causes of con-
tagion. But there are others quite as
dangerous, which are commonly supposed
to be harmless. The board reports that
there is too great an indifference to the
danger from kitchen wastes, which is
quite as great as from more offensive ac-
cumulations. The New Jersey board of
health has also directed attention strongly
to neglected cellars as a cause of diph-
liberia. This is a point of great import
ance, for the air in the cellar will surely
find its way up into the house. A vigil
liant cleanliness is the best preventive of
diphtheria.
NECESSITY OF ISOLATION.
The board reports tina the experience
of the past year has made the necessity of
isolation in the treatment of the disease
more apparent than ever. All the evil
dence tends increasingly to show that the
germs of the disease may be carried by
persons in good health who have been in
contact with the sick, that they find place
in clothing, bedclothes and all other lab
RIGS, adhere to the walls, and wherever
they settle retain their power for mischief
for a considerable time. II the patient is
properly isolated, these germs will die in
time, or can be destroyed by fumigation
after the patients recovery and removal.
The board recommend that the isolation
should be for a long time, at least until
entire recovery from sore throat,
A special evil is the too early return of
children to school after an attack. In
these two Observation-Disclosures and iso-
lation-the sole hope seems to lie against
the spread of diphtheria. A notable in
stance of the effective use of isolation and
disintection on a large scale has been af-
forded in Michigan. The state board Of
health enforced this policy in 116 out
breaks in 1886, in which there were 332
cases and rs deaths, but in 1902 outbreaks,
where no restrictive measures were taken,
there were 1850 cases and 1929 deaths.
This is sufficient to show that when diph-
liberia has actually broken out, its ravagos
can be much diminished by a stern quar-
antine New York Tribune.