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Hall, and during the day at the Dulwich Baths. During the year
119 phials of 8,000 units and 37 phials of 500 units were issued.
In previous reports reference lias been made to the necessity of
administering anti-toxin whenever this disease is suspected without
waiting for bacteriological confirmation of the diagnosis. The
swab report should, as a rule, be regarded as providing confirmatory
evidence of the disease. The non-detection in the laboratory of
organisms morphologically resembling the diphtheria bacillus
does not necessarily exclude diphtheria as the disease from which
the patient is suffering.
Diphtheria Prevention.
The attendances at the Council's Diphtheria Prevention
Clinic in 1936 numbered 1,449. A table recording the number of
persons in age groups who attended to receive the Schick test and
immunisation treatment appears on the preceding pages.
Daring the last year various types of diphtheria prophylactic
have been employed at the clinic. Toxoid Anti-toxin mixture has
been used for many years with excellent results, but it was desired
to determine whether these results could be improved upon. Goat
serum Toxoid Anti-toxin mixture was given a trial by Dr. Guy
Bousfield, the Clinic Medical Officer, in the same dosage and at the
same interval as the Toxoid Anti-toxin mixture formerly used. The
results were strictly comparable, it being found that in each case
3 or 4 per cent, of children were not effectively immunised by the
routine course. It would appear that this percentage of failure
ought not to be regarded as casting a slur on the effectivity of the
prophylactics. The reason is rather that a few children in every
hundred are exceptionally difficult to immunise, and often a considerable
number of extra injections is required in such cases to
effect the end in view.
Recently an attempt has been made to produce a very high
standard of immunity by the employment of one of the new
preparations, Alum-precipitated-toxoid, administered in a different
manner from that advocated by the manufacturers. This product
has hitherto been used either as a single injection, which has not
proved sufficiently satisfactory to recommend the procedure, or
as two injections, one of o'l c.c. followed by 0-5 c.c. at two or three
weeks' interval. The latter method has produced results fully
comparable with the old three-injection procedure with Toxoid
Anti-toxin mixture. In view of the fact that the more serious types
of diphtheria infection require a greater degree of immunity to give
protection against them, it was decided to attempt to achieve this
high degree of immunity by the routine use of three doses of this
most powerful prophylactic, Alum-precipated Toxoid. These have