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83
Chemists' Prescriptions, Analyses of. The London Insurance
Committee asked us some time ago to co-operate in order to ascertain
whether the prescriptions made up by chemists under the National
Health Insurance Acts were properly compounded, whether the
medicines supplied to insured patients were in all respects according to
prescription. Twelve prescriptions were issued and following the
receipt of the Public Analyst's reports certain prosecutions were
undertaken.
Two chemists were fined £1 each and £5 5s. costs. The unsatisfactory
feature of the cases was that the London Insurance Committee
refused to pay any part of the cost of the proceedings.
Diphtheria Contacts. In January, 1923, I commenced examining
every contact of each notified case of diphtheria whom I could persuade
to attend at the Town Hall for the purpose. The idea that the
nose and throat of every contact should be swabbed has been given up.
Only those who present signs of catarrh, redness, incrustation, patches,
etc., should be swabbed. In ordinary healthy throats the diphtheria
bacillus may or may not be found in a series of successive swabs. The
presence of a diphtheria bacillus, without clinical signs, is of no consequence
as a rule. A question may arise where the presence of a carrier
in a family or a class at school is suspected. The era of swabbing all
and sundry has passed. No authority nowadays is going, moreover, to
spend 3s. 6d. a time on a dozen contacts' throats. Each outburst must
be treated on its own merits. If a diphtheria bacillus is found, a
question arises as to whether it is a virulent or a non-virulent one; this
involves the use of guinea pigs at 10s. 6d. each, an expense which
cannot often be justified. As a disease, diphtheria is of much more
importance than others which seem to hold the attention of the people.
Diphtheria is a killing disease. It is quite possible that diphtheria
could be practically expelled from London. By the Shick test one can
tell whether a child is liable to take diphtheria or not, and by means of
a simple inoculation it is possible to make any unprotected child safe
from infection. Dozens of children have now been protected in the
Westminster area. What chance is there of making the London
children safe against diphtheria? Look what is happening with regard
to small-pox and vaccination. Thanks to vaccination small-pox was
expelled from the country. A new generation arose who objected to