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diagnosis in cases of Consumption is now acknowledged, as in
the early stages of this disease, the open-air treatment offers
hopes of good results; whilst the advantage of being able to
assure patients, or their friends, that the disease suspected is
merely (for instance) bronchitis or pneumonia, and not Consumption,
goes without saying. In connection with the Voluntary
Notification of Consumption, which now is' in force in the
Borough of Lambeth, the bacteriological examinations of sputa
become essential, and the numbers of such examinations have,
consequently, considerably increased recently.
In two samples, the Pneumococci Friedianderi were isolated.
Typhoid Fever.
385 samples of blood from suspected Typhoid cases have been
examined, and in 193 (i.e., 50.1 per cent.) the characteristic
reaction of Widal has been obtained, thereby settling the diagnosis
and enabling the necessary precautions to be taken. Many
doubtful cases have been discovered in this way, more especially
in connection with a local outbreak of Typhoid in 1900, due to
infected mangles.
A high dilution of the suspected blood-serum (one-sixtieth to
one-hundredth) is used, so that, where the reaction is wellmarked
and definite, the diagnosis is certain. When, however,
the reaction is slight, or but feebly marked, too much reliance
must not be placed on it as a certain diagnostic aid, at least in the
absense of some definite well-known clinical symptoms. A low
dilution of the suspected serum (one-tenth) is, in the Lambeth
experience, untrustworthy. The reaction depends on the fact
that the specific (Eberth-Gaffky) bacilli of Typhoid Fever lose
there power of movement and become collected into clumps (or
agglutinated, as it is called), in fluids containing the specific
anti-toxin of the disease, and this anti-toxin is developed naturally
in the blood of all patients suffering from Typhoid, very
shortly after the invasion of the disease, specially marked after
the 9th to 12th day (not before), and lasting (slightly) some (even
considerable) time after convalescence.
Other Examinations.
15 other samples were submitted as follow:—Urine (for
tubercle, gonococci, casts, etc.), 7; Ice Creams (for tubercle,
typhoid, etc.), 6; Liver (for hydatids), 1; Ulcer of Face (for
anthrax), 1.