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The epidemiology of diphtheria during the past decade is discussed, and special reference is made to the increase of this disease in England, Austria, Hungary and Germany. In the latter country, the greater incidence has been proportionate to the increase in density of the population.
No marked increase in mortality has been apparent in the countries as a whole, but in the large cities and certain sections, a higher death rate from diphtheria is pronounced owing to the malignant, toxic or septic types. In this connection, Düsseldorf, with a population of 450,000, is cited. In Düsseldorf, in 1921, there were 391 cases of diphtheria, with 22 deaths. The comment is made that since 1930 the death rate seems to have been increasing, especially in the hospitals for contagious diseases, where in the year named the rate was 52 per cent for toxic diphtheria. However, when the cases in which the