Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    260/976 (page 240)
    its large river, affords frequent instances of Croup ; and in some of the large towns of Australia, with their defective sanitary arrange- ments and large infantile mortality, Croup was not unknown years before the first appearance of diphtheria. The high mortality in Scot- land is not greatest in its most northern extremity; the mortality from Croup in the northern counties of England is generally over 1 per cent; bnt this is equalled and often exceeded in the warm south-western promontory of Cornwall, with Devonshire and Somer- set. The western shores of England, receiving the Atlantic moisture, show a higher mortality from this disease than the eastern. South Wales has the high rate of l-o per cent. This is not so much owing to its mountainous interior, as to its large mining population and the defective sanitary state of its large towns. The highest rate for England is in the populous districts of Lancashire and Cheshire; and here there can be no doubt that a dense town population, the children specially living under defective sanitary conditions, causes Croup to be particularly fatal. That it is not merely the combination of cold and moisture, may be shown by the returns from the south-western corner of Scotland, Wigton and Dumfries, the latter conterminous with our Northumberland and Cumberland, and with a rainfall* ex- ceeding that of any part of England. Though the temperatiu’e is some- times very low, it is more equable than that of many parts of our island, and the mortality from Croup, generally below 1 per cent, is some- times as low as 0'5. The classical Croup districts of Scotland still retain their pre-eminence ; they are not confined to the west coast of Scotland; the eastern coast is deeply indented by the sea, and not only do deep valleys of clay extend from these firths, but their shelv- ing shores leave a great expanse of ooze uncovered at every tide, and during the easterly winds, which here prevail for three months of the year with great bitterness, the characteristic cases of Scotch Croup occur. This part of Scotland forms an isthmus, only thirty miles in width, in the vicinity of which, and of the peninsula formed by the eastern firths, Croup is most fatal, the mortality often exceeding 2 per cent. As high a rate is found for Ireland, where imperfect drainage, unreclaimed bog, and a large expanse of inland water add to the influence of the Atlantic in causing a remarkable humidity of climate. The influence of season is illustrated by the quarterly reports for London ; an average of the ten years from 1814 to 1853 gives the number of deaths from Croup in each quarter as follows: first quarter, 95 • second quarter, 81 ; third quarter, 68; fourth quarter, 92 5; the greatest fatality being in the winter and spring; the greatest variation is found in the second quarter; the third quarter has the lowest number, and shows the least variation; the fourth quarter generally shows a considerable increase on the third, or warm quarter of the year; this was less marked than usual in the'year 1852; for while the deaths m » the third quarter showed a tendency to increase, being as high as 14, . At Wanlock Head, in Dumfriesshire, there was an estimated rainfall of 80 inches in the year 1801.