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precautionary measures against the spread of diphtheria. Should a
positive result be obtained in the case of children showing no evidence
of diphtheria, the presence of some measure of infection is assumed,
and much valuable light on the origin of outbreaks is obtained. Your
Medical Officer takes swabs of all contacts or suspicious cases whenever
they come to his notice.
The Council now provides diphtheria anti-toxin for the use of
medical men, including Poor Law Medical Officers. Practiti tiers in
the borough may obtain from the Public Health Department anti-toxin
sufficient for their purposes, upon sending a written order stating the
name, age and address of the patient, together with the doctor's name,
and stating that it is to be used for a poor inhabitant of the borough.
If the patient is able to pay, we find the medical man quite willing to
pay us the actual cost of the anti-toxin which he obtains for the patient
It is desirable that medical men should be aware of these facilities,
and emphasis laid on the importance of prompt treatment by anti-toxin,
and the saving of life which may be effected.
The cases were distributed in the various wards as follows : —
East 32, North 55, North-West 93, South 24, South.East 31, and
South-West 35. Two hundred and fifty-three cases were removed to
hospital.

This disease has been endemic in the borough for many years.
There has been no serious outbreak of the disease during the last ten
years, and only once in that time have we had 40 cases notified in the
one year.
During the past year we had 8 cases notified, as compared with 14
cases in 1918
The prevalence of this disease is generally considered an index of
the sanitary state of a district, and such a small number of cases in so
densely populated a town is an indication of a good sanitary condition
as regards its water carriage system, sewage, drainage and good pure
water supply.
Two deaths were attributed to the disease during the year.