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against various infections, of which diphtheria was one. Though
she could not be regarded as a fully immunised case her later
medical history was interesting as, like the first case, she contracted
diphtheria in a particularly severe form ; not knowing
anything about the history of the immunising injections, we were
somewhat puzzled by the fact that the throat condition cleared
up so rapidly after antitoxin, but when the doctor gave us this
information the explanation was obvious. The inference from
these cases is that preventive injections against diphtheria are
always of value, and that in the very rare instances in which they
do not confer complete protection they may still prove beneficial.
With the increase in the number of immunised cases we must
expect to meet with exceptions now and again and recent Toronto
work suggests that like some other preventive measures (e.g.
Typhoid) the immunity may become lessened after about five
years. Personally, I think that propaganda for prophylaxis
should take note of these points so that the occasional exceptions
will not tend to discredit a very valuable measure."
In my last Annual Report I emphasised the importance of
speed in the diagnosis and treatment of this disease. Once more
I would reiterate this advice and draw attention to the fact that
not only is antitoxin supplied free for any patient in the borough,
but that any and every scientific aid to the diagnosis and treatment
of this disease is at the hand of the family doctor on the
same terms if he will only ask for it. Speed, I almost said, speed
only, is required of him.
During the year there were unfortunately five deaths from
diphtheria, all of children under the age of seven. Three of these
patients died from heart failure, one from toxaemia and one from
other complications. In one case tracheotomy was performed.
Of these five patients the diagnosis was made in one case four
days after the onset of the disease, in one case the diagnosis was
made three days after onset, in two cases the diagnosis was made
two days after onset, and in one case the diagnosis was made at
once. In every case the patient was removed to hospital immediately.