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The new series of examinations, those of tubercular
material and of the blood in suspected cases of typhoid fever,
have not been made use of to any great extent. Fourteen
specimens of tubercular sputum have been received, in seven
of which a positive result was obtained. Eight specimens of
blood have been examined, in four of which the typhoid
reaction was obtained. It is to be regretted that these means
of diagnosis, both of which are almost absolutely certain in
their results, have not been more largely used, especially as the
medical men of a neighbouring Parish appear to do so to a
much greater extent.
The method of collecting the blood is very simple. It
is only necessary to prick the lobe of a clean ear with a surgical
needle, and receive the blood in a lymph tube, which is then
sealed at both ends. Care need only be taken not to burn the
blood in the sealing.
Two of the photographs appended to this report shew
the very characteristic appearances obtained by the Widal
method in typhoid fever.
I place a drop of the blood-serum and a drop of the
dilution of a young culture of typhoid bacilli side by side upon
a cover glass, and join the edges by a narrow line of fluid.
This allows of a slow mixture of the two drops, and the whole
process can be clearly seen, the typhoid culture being pure at
one end, and the diluted serum at the other, whilst at the
junction the process of " clumping " can be seen going on.
The difficulty of obtaining a rapid positive or negative
result of a reliable character in the examination of the milk
supply of the Parish, as regards the presence or absence of
tubercle bacilli, has not yet been satisfactorily overcome, but I
have now caused an apparatus to be constructed capable of
dealing with much larger quantities of the milk than have
hitherto been treated, and hope to be in a position to make
reports upon the subject very shortly.
The water supply from the three companies, Kent,
Lambeth, and Southwark and Vauxhall, upon whom the Parish
depends, has been several times examined, with results, upon
the whole, satisfactory, though it has at times been found