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Bacteriological examination is the only sure means for accurate
diagnosis of this disease, and also for determining when a case is free
from infection, as the bacilli or germs remain in the throat for considerable
periods after the disappearance of the membrane and during
convalescence, and no doubt such cases are the cause of the spread of
the disease, and no case ought to be considered free until examined
bacteriologically. Thirty to fifty per cent, of the cases examined by
the Health Department of New York—which was the first Sanitary
Authority to place at the disposal of the medical profession opportunities
for bacteriological examinations of suspected cases of diphtheria—
were found not to be diphtheria. This Health Department diagnoses
all cases bacteriologically before admission to the hospital wards;
reliable conclusions can be given in from twelve to twenty.four
hours.
Accurate diagnosis is really most important, for a non.diptheritic
case upon admission to a ward where there are a number of patients
suffering from true diphtheria, runs a great risk of developing the graver
disease with its constitutional symptoms—more especially it has been
found after the tracheotomy operation.
The Metropolitan Asylums' Board, recognising that many of the
patients sent to their hospitals as suffering from diphtheria have not
that disease, and in order to afford their medical officers facilities for