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those children who had shown evidence of harbouring other suspicious
organisms morphologically resembling Diphtheria bacilli
were removed to the "suspect" Ward in "B" Block for isolation
and further bacteriological examination. A similar procedure
was adopted with the children scattered throughout the various
Wards in "A" Block and in "B" and "C" Blocks. In this way
it was possible to exclude the "suspects" from the "contacts"
after the latter had been pronounced free, on bacteriological
examination, from Diphtheria or diphtheroid organisms.
The plan adopted of swabbing all fresh admissions to Infirmary,
after the children already in the Institution at the time
the outbreak began, resulted in a proportion of these fresh admissions
showing, on bacteriological examination, evidence of
Diphtheria bacilli being present in their noses or throats (or both).
These cases were not allowed beyond the Receiving Ward, and
were at once removed to the Metropolitan Asylums Board Hospital
on the order of the Medical Superintendent. It was apparent,
therefore, that to some extent, at least, children admitted from
other Institutions under the Board of Guardians control for other
complaints were sent to the Infirmary while harbouring Diphtheria
bacilli. In the absence of any proper means for dealing with
these cases at the Infirmary, it seemed most advisable that some
steps should be taken to ascertain their freedom from either
clinical or bacteriological evidence of Diphtheria before sending
them to that Institution from the Workhouse and other Institutions
under the Guardians' control. Representations were accordingly
made to the Board that this was probably one of the channels
by which infection gained entrance to the Infirmary, and suggesting
the means by which this risk would be minimised.
The Guardians, however, on the advice of the Medical Officer
of the two Workhouses from which most of these children came
to the Infirmary, did not see their way to carry out these suggestions.
Owing to the impossibility of retaining these cases in the
Receiving Room, while awaiting the result of the examination of
the swabs taken on their arrival at the Infirmary (many of these