London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
City of London 1922
[Report of the Medical Officer of Health for Port of London]
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Diphtheria—
| Date. | Name of Vessel, Port of Registry and Official No. | Where from. | No. of Cases | How dealt with. | |
|---|---|---|---|---|---|
| Brought forward | 25 | ||||
| Oct. | 2 | ss. " Herefordshire," of Liverpool, 120,903. | Rangoon | 1 | — |
| „ | 4 | Training Ship " Exmouth " (Grays). | — | 1 | Admitted to Eastern Hospital (M.A.B.). |
| 11 | ss. " Andania," of Liverpool. | Montreal | 1 | Landed at Plymouth. | |
| 11 | ss. " Highland Laddie," of London, 129,082. | Buenos Aires | 1 | Admitted to Port Sanitary Hospital. | |
| j t | 16 | Training Ship " Cornwall " (Purfleet). | — | 1 | Ditto. |
| 18 | Training Ship " Exmouth " (Grays). | — | 3 | Admitted to Eastern Hospital (M.A.B.). | |
| 20 | ss. " Naldera," of Greenock, 142,257. | Sydney | 1 | Admitted to Seamen's Hospital, Greenwich. | |
| 23 | Training Ship " Arethusa " (Greenhithe). | — | 1 | Admitted to Ship's Hospital. On shore. | |
| 27 | ss. " Skjold " (Danish) | Copenhagen | 1 | Admitted to Seamen's Hospital, Greenwich. | |
| 30 | Training Ship " Exmouth " (Grays). | — | 1 | Admitted to Eastern Hospital (M.A.B.). | |
| Nov. | 10 | Training Ship " Arethusa " (Greenhithe). | — | 1 | Admitted to Ship's Hospital. On shore. |
| Dec. | 5 | ss. " Moreton Bay," of Brisbane, 130,169. | Brisbane | 1 | Landed at Adelaide. |
| 18 | Training Ship " Exmouth " (Grays). | — | 2 | Admitted to Eastern Hospital (M.A.B.). | |
| Total | 44 | ||||
DIPHTHERIA.
Training Ship " Exmouth."—As formerly reported to your Worshipful
Committee the disease diphtheria has seemed to be in excessive evidence on board
the Training Ship " Exmouth " lying at Grays, and under the management of
the Metropolitan Asylums Board.
During the year out of some 800 boys dealt with there have been 30 cases in
all.
On the 23rd February, I wrote to the Medical Officer advising that a Schick
test of the whole personnel would be an advantage.
Some preliminary theoretical consideration of the present outlook on diphtheria
is essential to a full understanding of the case of the "Exmouth,"
especially a consideration of the Schick test.
1. By its use one can definitely determine which person is susceptible and
which insusceptible to diphtheria—that is, who in an epidemic may catch the
disease and who certainly will not.
2. In connection with the test a means of rendering those who are susceptible
to diphtheria insusceptible has been devised. It is one of inoculation with the
poison in conjunction with its antidote.
3. Up to the time of the Schick test it has been customary where extreme care
is taken to consider those persons, who present in their throats on swabbing a
bacillus which is in form, culture and staining, the equivalent of the Klebs Loeffler
bacillus, as suffering from or harbouring diphtheria.
4. Therefore the greater the amount of swabbing of throats and the more
the pathological test of bacteriology is applied, the more apparent diphtheria is
found.
In passing I would note that the care taken of the boys on the " Exmouth "
is excellent and the great resources of the Metropolitan Asylums Board, both
pathological and hospital, always at hand.
5. It is found by the Schick test that real insusceptibles are apparent susceptibles
according to the former pathological test.
6. A further test is now in use, namely, to determine by its capacity to render
animals ill, the virulence of a suspected bacillus from a suspected sore throat.