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Bacterioscopic Diagnosis of Diphtheria and Enteric Fever.—ln all
cases which are brought by medical practitioners to my notice, and in
which I think such a course desirable, I am now empowered by the
Public Health Committee of the Vestry to forward to the Jenner
Institute material for examination free of charge to the patient or his
friends. The exact significance qûa infectiveness, of the Klebs-Læffler
Diphtheria Bacillus is still unsettled, so far as regards its presence in
throats of normal appearance, or not presenting clinical signs of
diphtheria, so that I am still of opinion that notification should be
based rather upon clinical evidence of diphtheria, than upon bacterioscopic
examination of removed secretion. Evidence is accumulating
that the Klebs-Læffler bacillus is more widely spread amongst the
general child population than was formerly anticipated, but the exact
significance of this fact in its relation to localised occurrences, or
epidemic outbursts, has still to be determined. In my opinion, swab
examinations, as a part of municipal administration, are only called for
where clinical symptoms or surrounding circumstances point to the
presence of diphtheria in its generally recognised forms.
The Widal Serum reaction for enteric fever might with advantage
be more generally employed in cases of doubtful nature, than has
hitherto been the case. In one case, at least, it has proved of great
use in this parish ; and its earlier adoption would tend greatly to the
advantage of the patient in the crowded homes of the poor, by securing
removal to hospital at a time when treatment and nursing are of the
greatest value, and by removing a source of danger to others in
the house at the earliest possible moment. In the tenement homes of
the poor, the nursing at home of a case of enteric fever, involves
a considerable amount of risk of infection to the healthy inmates.
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