The bacteriology of diphtheria : including sections on the history, epidemiology and pathology of the disease, the mortality caused by it, the toxins and antitoxins and the serum disease / by F. Loeffler [and Others] Ed. by G.H.F. Nuttall and G.S. Graham-Smith.

  • Nuttall, George Henry Falkiner, 1862-1937.
Date:
1908
Catalogue details

Licence: In copyright

Credit: The bacteriology of diphtheria : including sections on the history, epidemiology and pathology of the disease, the mortality caused by it, the toxins and antitoxins and the serum disease / by F. Loeffler [and Others] Ed. by G.H.F. Nuttall and G.S. Graham-Smith. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    642/784 (page 580)
    The Proportion of Diphtheria Cases sent to Hospitals. In using hospital statistics for studying diphtheria mortalities it is important to know what proportion of all cases occurring in the district are sent to the hospitals, and what, in general, is the character of these cases. In many cities, owing to an increase in hospital accommodation, to more efficient inspection at the homes, or to other reasons, more cases are sent to the hospitals than in former years. Thus in Berlin between 1884 and 1887 only 26—30 % of the total number of cases of diphtheria were sent to hospitals. In 1897 there were 57%, in 1898, 60%, and in 1899, 63 % so treated (Gottstein, 1901, p. 605). On the other hand in New York up to the past year there has been no increase of hospital facilities beyond the increase of population, and there has been no appreciable change in the percentage of cases treated in the hospitals. In making use of hospital statistics it is also necessary to be familiar with the character of the service, i.e. the kind of cases which ordinarily come there for treatment. Thus in some European hospitals cases needing tracheotomy are treated in the surgical division, and are not included in statistics published by the medical division. The mortalities in the two divisions therefore ditfer enormously, and the statistics cannot be compared with those from hospitals in which this division is not made. These differences are well shown by Table VIII. (p. 587) compiled by Glaser (1896) from the records of the Hamburger AUge- meinen Krankenhaus, 1872—1891. The Influence of the Day of Admission on the Prognosis of Hospital Gases. This subject is of importance because of its bearing on antitoxin statistics. There is no doubt that in general the earlier a patient suffering from diphtheria receives suitable care and surroundings, as in a hospital, the better his chance of recovery, irrespective of any specific method of treatment. This fact, which was made use of by those who denied the efiScacy of serum treatment, is clearly demonstrated in the following table, published by Glaser (1896) showing the mortality amongst 619 children treated in a hospital without antitoxin. Here we see that the increase in mortality is quite distinct though somewhat irregular. It is merely necessary, however, to compare these