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EPIDEMIOLOGICAL SOCIETY. MONDAY, DECEMBER 5TH, 1859.
1st. That the accoucheur should attend solely and strictly to different parts of the kingdom at intervals within the last his own avocation, and that it therefore necessitates the pre- twenty years. sence of a second practitioner in the room. 2nd. The unusual prevalence of throat affections of all 2ndly. The needlessness of incurring any risk of asphyxia or kinds, and not unfrequently of a peculiar kind, which might be death, although such cases in the lying-in room are rare com- described as of a quasi diphtheric character, prior to or conpared with patients about to undergo surgical operations. temporaneously with the present epidemic of diphtheria. 3rd. The concurrent or intercurrent prevalence, in the same 3rdly. That under ordinary circumstances, where matters are favourably and naturally progressing, it tends to depress locality, of epidemic diphtheria with epidemic scarlet fever, the system, leaving the entire expulsion of the fcetus to the and the occasional occurrence of a diphtheric affection of the efforts of the uterus, supplied as it is by organic nerves, whilst fauces in scarlet fever. the muscles of animal life, which so forcibly assist the uterus, The whole of these facts have an important bearing upon are almost paralysed. the history of the development of the present epidemic of diph4thly. By its over-administration, the danger both to child theria:-lst, in reference to the introduction of the disease into and mother. the kingdom from without; 2nd, in reference to the causes Cases illustrative of these objections were related, the ex- which have led to the development of the epidemic; 3rd, in ception to the general rule being when the mother was of a reference to the relation of the disease to cognate affections delicate and nervous temperament, and then only was chloro- and to scarlet fever. Upon all these points the foregoing facts form administered in a very modified form, more to attracL the are valuable as suggestive of further inquiry, and as indicating attention of the patient from her fears than to lessen the natural the direction in which that inquiry should tend, as well in throes of labour. In protracted labour, the author had expe- those districts in which the epidemic has prevailed as in those rienced much benefit in its administration; and although the in which it now prevails. 4th. The doubtful contagiousness of the disease in some dispains for the first ten minutes appeared arrested, they afterwards returned, more strongly, and with greater regularity; the tricts; its undoubted contagiousness in others. 5th. The insanitary state of the majority of the localities in rigidity relaxed; a more copious secretion of mucus occurred; the patient’s countenance became less anxious; the pulse, at which the disease occurred. first quickened, became stronger; and the child was born in a 6th. The greater liability to the disease being in the first decennium, or, to narrow the question, the second quinquenvery short time. Cases illustrating this were related. Mr. Pettigrew, in his limited experience, bore out Dr. Simp- nium of life. son’s observation, that haemorrhage seldom or never occurred ith. The proportion of males in 100 cases being 42’3; of after the use of chloroform. In the only case in which Mr. females, 58.’2. Pettigrew had recourse to the forceps, and in which he had not 8th. The nature of the treatment indicated :--(1) The appliadministered this anaesthetic, heamorrhage did occur, and to so cation of more or less stimulating or caustic applications to the excessive a degree that the patient nearly lost her life. diseased parts. (2) The regulation of the excretions. (3) After some observations upon the author’s method of ad- The sustentation of the powers of the system. In concluding their Report, the Committee remarked that, ministering chloroform-namely, upon a thin pocket-handkerchief-the following table was exhibited, showing his expe- although the information obtained by them in the present inrience during the last five years, the instrumental cases, in quiry was exceedingly imperfect, yet it was sufficient to show proportion to the actual number of cases cited, arising from that, if the inquiry had been supported by the members of the tive consultations to which he had been called, where the Society to the extent that the Committee had hoped that it would have been, a large amount of most valuable information forceps were resorted to in order to save the child :respecting diphtheria would have been obtained-information of a character that could be obtained in no other manner than
by the systematic co-operation
of many and widely separated observers to one and the same end. The Committee suggested that the Society should take into consideration the propriety of adopting other and additional means (if such could be devised) for promoting or ensuring the more satisfactory co-operation of its members in such inquiries as the Society may set on foot; for the Committee felt assured that the present inquiry had After some discussion, the Society actjourned. proved in a great measure abortive, not so much from indisposition of the members to aid. as from an erroneous estimate of the value of the information which they possessed relative to the subject of inquiry. Thus, it was stated that in the majority of EPIDEMIOLOGICAL SOCIETY. letters with which the Committee had been favoured, in answer to their circular, the writers had contented themselves simply MONDAY, DECEMBER 5TH, 1859. with stating that diphtheria had not appeared in their neighDR. BABINGTON, PRESIDENT. bourhood, or that they had seen but one or two cases of the disease, and consequently their experience would be of no value to the Committee ; yet the Committee had specifically MR. J. N. RADCLIFFE read the asked for particular information respecting the prevailing chaREPORT OF THE DIPHTHERIA SUB-COMMITTEE. racter of throat affections where the disease had not manifested It stated that, although in February last upwards of 200 itself, and for many items of information where it had, even if circulars, as kng for information, and containing suggestions it were but in a solitary instance. for observation, had been distributed amongst the members The Committee further suggested, in respect to the present of the Society and others in various parts of the kingdom; and inquiry, that additional information should be specially sought notwithstanding that the aid of the profession generally, in theconcerning1. The date of the first case or cases of diphtheria which inquiry, had been sought through the medical journals, the Committee had received, during a period of ten months, only occurred in any district. thirteen specific reports, and twenty-eight general replies. 2. The occurrence of diphtheria in a sporadic or epidemic Hence, the results of the inquiry were entirely insufficient to form prior to the present outbreak. form a basis for a general history of the rise and progress of 3. The character of the throat affections which occurred condiphtheria in the kingdom. Nevertheless, the information temporary with diphtheria, or, that disease being absent, the which has been received respecting the disease is not without character of the throat affections which had been observed imvalue,-First, from the additional light which is thrown, in mediately prior to its appearance in 1857 and subsequently. several respects, upon the development of the epidemic; and, 4. The relationship existing between diphtheria and scarlet secondly, as showing the highly important knowledge which fever. If the suggestions of the Committee respecting any furmight be obtained respecting epidemic diseases from an inquiry ther inquiry were adopted by the members, the Committee exsuch as that conducted by the Committee, if it were generally pressed a willingness to continue their duties some time longer, supported by the members (particularly the non-resident notwithstanding the disheartening results which had attended members) of the Society. The facts of chief importance which them hitherto. have been ascertained by this inquiry may be summed up A discussion followed, in which Dr. Milroy, Dr. Camps, Dr. thus : M’William, Dr. Greenhow, Dr. Sanderson, and Dr. Babington lst. The probable occurrence of sporadic diphtheria in the part. counties of Kent and Esst,,x in the vears 1853 and 1854: also in Mr. Radcliffe replied. .
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by the systematic co-operation
of many and widely separated observers to one and the same end. The Committee suggested that the Society should take into consideration the propriety of adopting other and additional means (if such could be devised) for promoting or ensuring the more satisfactory co-operation of its members in such inquiries as the Society may set on foot; for the Committee felt assured that the present inquiry had After some discussion, the Society actjourned. proved in a great measure abortive, not so much from indisposition of the members to aid. as from an erroneous estimate of the value of the information which they possessed relative to the subject of inquiry. Thus, it was stated that in the majority of EPIDEMIOLOGICAL SOCIETY. letters with which the Committee had been favoured, in answer to their circular, the writers had contented themselves simply MONDAY, DECEMBER 5TH, 1859. with stating that diphtheria had not appeared in their neighDR. BABINGTON, PRESIDENT. bourhood, or that they had seen but one or two cases of the disease, and consequently their experience would be of no value to the Committee ; yet the Committee had specifically MR. J. N. RADCLIFFE read the asked for particular information respecting the prevailing chaREPORT OF THE DIPHTHERIA SUB-COMMITTEE. racter of throat affections where the disease had not manifested It stated that, although in February last upwards of 200 itself, and for many items of information where it had, even if circulars, as kng for information, and containing suggestions it were but in a solitary instance. for observation, had been distributed amongst the members The Committee further suggested, in respect to the present of the Society and others in various parts of the kingdom; and inquiry, that additional information should be specially sought notwithstanding that the aid of the profession generally, in theconcerning1. The date of the first case or cases of diphtheria which inquiry, had been sought through the medical journals, the Committee had received, during a period of ten months, only occurred in any district. thirteen specific reports, and twenty-eight general replies. 2. The occurrence of diphtheria in a sporadic or epidemic Hence, the results of the inquiry were entirely insufficient to form prior to the present outbreak. form a basis for a general history of the rise and progress of 3. The character of the throat affections which occurred condiphtheria in the kingdom. Nevertheless, the information temporary with diphtheria, or, that disease being absent, the which has been received respecting the disease is not without character of the throat affections which had been observed imvalue,-First, from the additional light which is thrown, in mediately prior to its appearance in 1857 and subsequently. several respects, upon the development of the epidemic; and, 4. The relationship existing between diphtheria and scarlet secondly, as showing the highly important knowledge which fever. If the suggestions of the Committee respecting any furmight be obtained respecting epidemic diseases from an inquiry ther inquiry were adopted by the members, the Committee exsuch as that conducted by the Committee, if it were generally pressed a willingness to continue their duties some time longer, supported by the members (particularly the non-resident notwithstanding the disheartening results which had attended members) of the Society. The facts of chief importance which them hitherto. have been ascertained by this inquiry may be summed up A discussion followed, in which Dr. Milroy, Dr. Camps, Dr. thus : M’William, Dr. Greenhow, Dr. Sanderson, and Dr. Babington lst. The probable occurrence of sporadic diphtheria in the part. counties of Kent and Esst,,x in the vears 1853 and 1854: also in Mr. Radcliffe replied. .
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took
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°
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