A contribution to the natural history of scarlatina derived from observations on the London epidemic of 1887-1888, being a dissertation for the degree of doctor of medicine in the University of Oxford / by D. Astley Gresswell.

  • Gresswell, Astley.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to the natural history of scarlatina derived from observations on the London epidemic of 1887-1888, being a dissertation for the degree of doctor of medicine in the University of Oxford / by D. Astley Gresswell. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    21/226
    that the death-curve rose while the admission-curve fell in November. In this connection it may be stated that, as T shall show later, the severity of my cases was greatest among persons attacked in October, and the first three and a half weeks or so of November ; and that it began to fall off rapidly afterwards. Again, the fall in the death-curve would naturally be somewhat anticipated by that of the admission-curve, and the more so as the former is derived, not from the actual dates of the deaths, but from the dates of their registration. Still it is not clear that these considerations altogether explain the fact that, whereas the ascents of the two curves are closely, their descents are not so closely parallel. The maintained elevation of the death-curve in December 1887, and January, February, and March 1888, may have been due either to abstention from hospital among the classes which had been using the Board's hospitals, or to a greater mortality among classes which do not resort to these hospitals. However this may be, there can be no doubt that the facts portrayed in these curves, confirmed as they are by curves drawn for previous years by other observers, show that from about June 1887 to July 1888 there was in London but one rise and fall, one wave of prevalence of Scarlatina equi- valent in severity to the hospital-scarlatina ; and that it was at its highest in the last four months of 1887. Moreover, the numbers of admissions from each of the Parishes and Unions of the Metro- politan District show that the wave of prevalence of hospital- scarlatina in these several areas took practically the same course as that which has been depicted for the whole of London, so that the probability that the epidemic was essentially one is thus confirmed. It may be well to mention the numbers of scarlatinal patients admitted into the several hospitals of the Board from Lambeth, Wandsworth, and Clapham, districts to which most of my patients (at least most of those who were attacked in November, December, and January) belonged. The numbers admitted from these districts in successive four-weekly periods, commencing with January ist, 1887, and ending October 4th, 1888, were as follows, viz. 19, 15^ 22, 20, 26 30, 44, 53, loi (Aug. II, 1887 to Sept. 8), 184 (Sept. 8 to Oct. 6), 195 (Oct. 6 to Nov. 3), 178 (Nov. 3 to Dec. i), 165 (Dec. I to Dec. 29), 119 (Dec. 29 to Jan. 26, 1888). 87 (Jan. 26 to fm'?\'' /^l^^' \ 39, 54 (Aug. 9, ioo«, to Sept. 6), and 51.