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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    ( ,fi) In considering the decline in hospital fatality, it is necessary to bear in mind that, the tendency of scarlet fever to prove fatal depends largely upon the age of the patient. This is shown in the following table:— Showing Percentage Fatality at Various Ages of 92,615 Cases Admitted into the Asylums Board’s Hospitals in the Years 1871-95. Ages 0—5 5— 10— X5~ 20— 25— 30— 35- 40 upwards. i6‘9 5*o 2’2 2*4 25 2-8 4*3 5-o 6*0 The fatality at ages under five years being so enormously higher than at subsequent ages, it is evident that the fatality in a given number of cases admitted to hospital will vary directly with the proportion it contains under five years of age, and that in this way the decline in fatality above observed may be accounted for. Such, however, is not the case, as the following calculation, made from Asylums Board statistics, shows:— Admissions to Hospital. Period. Total. Under 5 years. Percentage under 5 years. 1871-86 15,480 4,112 26*5 1887-89 14,826 4,415 29 1890-91 U.799 3,548 30- 1892-95 50,510 14,462 28-6 The total cases admitted to the Metropolitan hospitals in the first period contained a smaller proportion of cases under five years of age than in any period since. One may also assume that this is true of the admissions to Glasgow hospitals, and conclude that the reduction in fatality in these hospitals has not been due to a variation in the age incidence of the cases admitted. The following Table O compares the hospital fatality with the mortality for the whole city in each case. TABLE O. Glasgow. London, Hospital Fatality* City Mortality Hospital Fatality* per 100 Cases. City Mortality Period. per 100 Cases. per 100,000 Population. Ferer Hospital. Asylums Board Hospitals. per 100,000 Population. 1861-65 — 14.1 1 [• 12.6 112 1866-70 20*3 141 II’IJ — 5 1871-75 x3’8 ] x45 | 1 I0‘3 ] I 10*8 ] ! 57 ) 1876-80 12*2 }■ 12*6 52 88 n'5 ho*5 13-2 117 62 54 1881-85 11*7 J 66 ! 1 9.8 J 11*2 ! 1 42) 1886-90 1891-94 *•3} » 38 | 35 i 36 4*2] i-8 J k° 9*o 1 6*5 J f 7*7 8I« * The arithmetical mean of the rate for each year. Shewing the Percentage Reduction in Fatality and Mortality During the Period 1886-94, as Compared with the Period 1871-85. Percentage Fatality. Mortality. Fatality. Mortality. Reduction 40*5 59 34 537 It may be remarked that in the above comparison I am contrasting a fifteen-year period with a nine-year period, but it will bejseen from Table N that the total cases dealt with, or units compared, in the fifteen-year period are much smaller than in the nine-year period. The cases dealt with in years prior to 1871 are so few that I hesitated to employ them in making such an important comparison. It will, however, be observed that the fatality was highest in the furthest back periods, and amounted to 20 per cent, in Glasgow, where it now is only 6*3 per cent. In thus dividing the whole period to which these hospital statistics refer, my only object was to obtain reliable data for comparison. The comparison thus made shows that the mortality-rate has fallen 50 to 60 per cent., while the fatality-rate has fallen 30 to 40 per cent.