A contribution to the natural history of scarlet fever : based upon official statistical records of mortality and morbidity / by John T. Wilson.

  • Wilson, John T.
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the natural history of scarlet fever : based upon official statistical records of mortality and morbidity / by John T. Wilson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ( *3 ) Again, in Vol. II., p. xxx.: “ In those parts of the country in which the distinction of colours and parentage was made, it (scarlet fever) caused a much greater proportion of deaths among the whites than among the coloured. More valuable statistics are forthcoming in the Eleventh Census (1890), where death-rates based upon population are to be found. Thus from the volume dealing with Boston and Philadelphia the following is obtained:— Average Annual Death Rates, per 100,000 Population, for the Six Years ending May 31ST, 1890, from Scarlet Fever. Boston. Philadelphia. White. Coloured. White. Coloured. 36*8 100 26-8 9 8 These statements and figures would lead us to believe that Negroes and Red Indians are less liable to the disease than whites. The liability to scarlet fever depends chiefly upon susceptibility to the disease and exposure to its infection. Should it be the case that the coloured races were equally exposed to infection with the whites, and that the age constitution of the different races were similar, then it might be concluded that the coloured races are less susceptible to scarlet fever than the whites. THE PROGRESS OF SCARLET FEVER MORTALITY COMPARED WITH OTHER DISEASES. No attempt at an explanation of the reduced mortality from scarlet fever could be considered complete which did not take into account the progress of mortality from other and similar diseases. It may, then, at this stage be advisable to consider the information set forth in Diagram VI., which shows how the quinquennial rates of mortality during 1871-95 have varied from the rates of 1861-70 for all causes, the seven chief zymotics, and phthisis. The mortality rates for each of the diseases compared show some evidence of a decline, which in the case of diphtheria, measles, and whooping-cough is trifling and unsteady, and contrasts very strikingly with the progress of the mortality from scarlet fever, “fever * and phthisis. Note the influence of these different diseases upon the general mortality, which has shown a steady cumulative decline, until the reduction in 1891-95 was 376 per 100,000 from all causes. This reduction might be summed up as follows :—Phthisis, 103; scarlet fever, 79; “fever,” 70; diarrhoea, 33 ; small-pox, 14; whooping-cough, 13; measles, 3; diphtheria, nil • and the balance of other causes 64. With the exception of phthisis, no disease has contributed more to the reduction in the general death-rate during the past twenty-five years than scarlet fever, and its association in this respect with “fever” and phthisis is a circumstance which should be kept in view, Other causes expresses the balance of increase and decrease in all other diseases. PART II. CAUSES OF DIMINUTION IN SCARLET FEVER MORTALITY IN GREAT BRITAIN. Proximate Causes of Variation in Mortality.—Variations in scarlet fever mortality depend immediately on the prevalence of the disease, and its tendency to prove fatal. The death* rate is the resultant of two factors, the morbidity-rate and the fatality-rate. The former indicates the quantity, the latter is generally believed to indicate the quality or type of disease, which from its earliest recognition in this country has been known to vary greatly during the course of an epidemic, and in comparing one epidemic with another; hence the nomenclature, Scarlatina Simplex, ** Fever ” includes typhus, enteric, and simple and ill-defined.