24 KANSAS UNIVERSITY QUARTERLY. 



based on his observation in his own county, on the effect of sanitar}' 

 environment, of wealth or poverty, of locality, of meteorological 

 conditions and of certain articles of food on the origin and spread 

 of diphtheria. ' About forty-five answers were received from various 

 parts of the state. These answers seem to me to be of considerable 

 value, not only for the information given in regard to diphtheria, 

 but because they give us some idea of the opinions held b}' the 

 health officers of the state in regard to this disease. It is to a great 

 extent the duty of these officers to take measures to prevent out- 

 breaks of infectious diseases and to control epidemics, and it is of 

 value to know on what they base their judgment in this work. I 

 have, therefore, given considerable attention to these letters. 



The information obtained has been classified as follows, and will 

 be taken up in the order given: Age, sex, color, season, metero- 

 logical conditions, topography and geographical location, sanita- 

 tion and some other agents which may affect the spread of 

 epidemics. 



As to the influence of age on diphtheria, little information could 

 be obtained from the records of this state, and this information is, 

 perhaps, of little value; for there is no reason to think that the 

 ages of greatest mortality are any different in Kansas from what we 

 find in the records of other states and countries. In the report of 

 an epidemic in Wichita in i8gi, the average age of fatal cases was 

 given as 5.4 years. In the United States Census Report for the 

 year ending Ma}' 31, i8go, it is reported that ig6 of the total 385 of 

 deaths from diphtheria in Kansas during that year occurred under 

 five years, and the largest number, 58, was given for the second 

 year of age. Out of 259 deaths from croup during the same year, 

 2og occurred under five years. In Michigan the average age of 

 fatal cases in a four year period ending in 1894 was 8.4 years. In 

 the Massachusetts reports it is stated that the greatest incidence in 

 that state is on the period o to 5 years; in England and Wales Dr. 

 Thorne puts it on the age period 3 to 12 years. 



There is no information in our reports on the influence of sex on 

 diphtheria, except during the years 1886 to i8go inclusive. During 

 these five years 453 deaths are reported in which the sex is speci- 

 fied; and of these 244, or 53.86 per cent, are males and 2og, or 

 46. 14 per cent, are females, a difference of 8.72 per cent. Aver- 

 aging the school population during these years, it is found that 

 51.4 per cent are males and 48.6 per cent are females, a difference 

 of 2.8 per cent. If we can trust these reports, therefore, it is 

 shown that the disease was slightly more prevalent among males 

 than females during that period. 



