(1) That Diphtheria prevails to only a moderate extent
in Carlisle and neighbourhood, but that its manifestations have been more marked during the past five years
than at any previous period.
(2) That it is pre-eminently a contagious disease and
that infection from person to person had much to do with
(3) That there is a special incidence of the disease,
fatal and non-fatal, on the age-period 3 to 12.
(4) That the female sex is more liable to attack than
the male sex.
(5) That Scarlet Fever, Measles, Whooping Cough, Epidemic Influenza, and the Puerperal State are active
predisponents of the disease.
(6) That apparently simple throat illness may beget
Diphtheria by the progressive development of the property of infectiveness.
(7) That season influences the disease which shews a
special incidence in the first and fourth quarter of
(8) That it is influenced by meteorological conditions
such as rainfall and soil dampness.
(9) That School attendance has an important connection
with the causation and diffusion of Diphtheria.
(10) That the disease in its occurrence shews a distinct
preference for the better-class parts of the city, while
the slums and more densely populated districts are less
(11) That gross defects in sanitation influence the disease by inducing a debilitated state bf the system in
the individual, which favours the reception of the contagion.
(12) That there is evidence that bovine disease and
certain diseases of lower animals - cats, fowls and pet
birds - are capable of producing diphtheria in the human
(1) That care should be exercised in the selection of a
site for dwelling houses. A dry soil, the avoidance of
insanitary effluvia and faulty drainage, ample ventilation, free perflation of air, and abundant access of sunlight are matters of importance which demand primary
(2) That during periods of Epidemic Diphtheria it would
be well to include cases of apparently simple "sore
throat" in the list of notifiable diseases. A precedent was initiated by the Health Authority of this City
in the Autumn of last year, when, in view of a possible
visitation of Cholera it was deemed advisable that during a stated period of 3 months all cases of diarrhoea
be reported to the Medical Officer of Health.
(3) That in view of the important part played by School
attendance in the diffusion of diphtheria:-
(a) Teachers be systematically instructed in the salient symptoms of the leading Zymotic diseases in such a
way as to help them to recognise the beginning of these
(b) Teachers be led to attach more importance than
they do at present to the occurrence among their pupils
of "Colds" and "Sore throats"
(c) At least twice a year - say at Christmas and Midsummer the schools be thoroughly and systematically disinfected, sulphur being employed for fumigation, and the
wood work washed with sublimate solution.
(d) That in as much as school attendance officers,
with more zeal than discretion, too frequently force
sickly or infected children to school, it would be well if school boards would recognise their real responsibility in the matter, and following the example of
Sanitary Bodies, fee the practitioner for a specifically
worded certificate; much would thus be done to remove a weak
point in their present administration.
(e) That during seasons of Diphtheria prevalence,
periodical inspections of the throats of all the children
attending school should be instituted.