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by far the most common. Thus, I find that no less
than 105 of the 504 cases of scarlet fever admitted
showed evidence at one or other time during their
stay in hospital of this mixed infection. Seventythree
out of this number suffered from scarlet fever
and nasal diphtheria, whilst the remainder suffered
from scarlet fever and faucial or throat diphtheria.
I am of opinion that a thorough bacteriological
examination should be made of the throats and noses
of all patients suffering from scarlet fever, on
admission. If such a practice were in force, and the
cases showing a double infection isolated in a separate
ward, there is no doubt that outbreaks of diphtheria
in the scarlet fever wards would be of much rarer
occurrence, and, consequently, the incidence of combined
attacks would hardly reach the somewhat high
proportion as above stated.
The necessity for a bacteriological examination
of the throats and noses of all patients suffering from
scarlet fever at the time of their admission, will be
explained if it is understood that such patients very
frequently harbour diphtheria organisms, and yet at