BARBER: DIPHTHERIA IN KANSAS. 27 



and school attendance, which may have much influence on the 

 spread of epidemics, are not the same in this country and in 

 England. 



Since our reports give so little information in regard to the 

 monthl}' mortality of diseases, it was impossible to determine 

 whether there was any relation between the meteorological condi- 

 tions of a given month and its death rate from diphtheria. In 

 table II of this article the yearly mortality of each of the twelve 

 years is compared with the average rainfall, the mean annual tem- 

 perature and the relative humidity. It is obvious that such a com- 

 parison is of much less value than a comparison by months; since 

 the distribution of certain kinds of weather in the year may be of 

 much greater influence than the average amount. However, a 

 brief summary of the meteorological data of this table will be given 

 for what it is worth. 



If we take the years i88g, 1891, 1892, 1895, 1896 and 1897, in 

 which the diphtheria death rate is reported to be equal to or above 

 the average, we find that in four of the six the annual rainfall was 

 above the average, and in all except 1892 and 1895 the relative 

 humidity was above the average. The temperature was above the 

 average in three, and of these three two show a rainfall below the 

 average. An examination of the meteorological data of each month 

 of the years 1887, 1888 and 1889, in which the monthly mortality 

 from diphtheria is given in our reports, leads to nothing further 

 than the general conclusion that there is less diphtheria in the 

 warmer, months of the year. 



In the blank sent out to the county and city boards of health in 

 tliis state the following questions was asked: "What meteorologi- 

 cal conditions seem to favor the prevalence of diphtheria? In 

 particular what is the effect of very dry seasons or of cold, wet 

 weather in early autumn, such as we had last October?" Of those 

 who answered this question, twelve were of the opinion that cold, 

 wet weather favors the prevalence of diphtheria, three of them 

 putting emphasis on cold, wet weather out of season. Two men- 

 tioned cold, dry weatiier, one of these stating that such weather 

 may favor a more malignant type of the disease. One had noted 

 the occurrence of an epidemic in warm, wet weather in early 

 spring, and another was of the opinion that cloudy, wet weather 

 with temperature just above freezing induced the disease. Four 

 mentioned wet weather without making any statement in regard to 

 temperature, and one, cold weather, without mentioning the hu- 

 midity. Other opinions were: drouth, one; sudden changes, one; 



