Encyclopædia Medica, Vol. 7 (Classic Reprint)
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Produktbeschreibung
Excerpt from Encyclopædia Medica, Vol. 7 Since then it has been and still is, more or less, prevalent all over Europe and in North America and Australia; to a less extent also in certain districts of South America, South Africa, India, and China. Etiology. At the present day, therefore, diphtheria is a very widely spread affection. The accumulation of properly compiled records of the fatal cases in various countries during the past twenty-five to fifty years has enabled inquirers to elucidate several important facts with respect to its etiology. Amongst the most recent and valuable researches in this field are those of Newsholme. This author draws conclusions, of which the following is a brief summary: Diphtheria has a tendency to spread from one place to another by the ordinary channels of communication. In certain years diphtheria may be pandemic over whole countries or a continent. The amount of endemic diphtheria varies greatly for different) countries and cities; but in no town from which records have been obtained is there a complete absence of the disease in a single year since the records commenced. In places where the amount of endemic diphtheria is not great, epidemics tend to occur in cycles, the intervals between the cycles being very variable for different places. The duration of an epidemic is also variable, but is usually longer in large than in small cities or towns. Before the appearance of Newsholme swork it had been shown that for England and Wales one of the most striking features with respect to the prevalence of diphtheria was that, whereas up to 1880 the disease was incident upon the rural to a greater extent than upon the urban population, since that date the reverse has been the case; there has been an increase both in rural and urban diphtheria, but the urban incidence has risen to a much higher degree than the rural. London has especially suffered. Newsholme sobservations show that this increase in urban diphtheria is not confined to England and Wales, but has also occurred in countries so widely separated as the United States, Japan, and South Australia. It is reasonable to suppose that the wonderful improvements effected during recent years in our means of transit have had no small share in contributing to this increase. Like most infectious diseases, diphtheria has its special seasonal prevalence, which, when estimated by the recorded deaths, is in this country from September to the end of the year. In London a marked rise in the notifications is observed in July. The consideration of the influence of soil and climatic conditions upon the prevalence of diphtheria has led to considerable diversity of opinion. While some writers deny that these conditions exert any material effect, it is held by others that a soil which is continually moist and impregnated with organic refuse is favourable to both the existence and virulence of the disease. Xewsholme, in the work from which we have already quoted, gives the results of his inquiries into the relation between epidemic diphtheria, the rainfall, and the level of the ground-water. The general conclusions to which he comes are abbreviated by himself as follows: An epidemic of diphtheria never originates when there has been a series of years in which each years rainfall is above the average amount. An epidemic of diphtheria never originates or continues in a wet year (i.e. a year in which the total annual rainfall is materially above the average amount), unless this wet year follows on two or more dry years immediately preceding it. The epidemics of diphtheria, for which accurate data are available, have all originated in dry years (i.e. years in which the total annual rainfall is materially below the average amount). The greatest and most extensive epidemics of diphtheria have occurred when there have been four or five consecutive dry years, the epidemic sometimes starting near the beginning of this series, at other times not until nea
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