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57
Although from time to time I have to remind practitioners
that the help which may be obtained from the examinations of
the swab by a bacteriologist is merely in the nature of assistance
towards making the diagnosis, yet some medical practitioners
still seem to be relying on the fact of having obtained a definite
positive or negative result before deciding to notify the case,
and in some instances the 24 hours delay in obtaining this
bacteriological result is of very serious moment to the patient.
This practice was particularly brought to my notice again recently
in connection with a fatal case of Diphtheria. When I called
at the house for another purpose I was asked by the parents
to see the suspected diphtheria case and immediately was able
to diagnose the case as one of Diphtheria, although the medical
practitioner concerned was patiently waiting for the bacteriological
result to be communicated to him and was with a certain
amount of difficulty persuaded to notify the case before such
result had been obtained. The removal to hospital, however,
was effected as speedily as possible; unfortunately with the
fatal result within the next 48 hours.
The continuous and long-continued prevalence of
diphtheria in this district has caused much thought to be given
to the question, and I am pleased to be able to inform the
Council that there appears a strong likelihood that a definite
method of attack against this disease on purely preventive
lines is at last within sight, for a method has been discovered
for testing persons, particularly children, to see whether they
are susceptible, or not, to the attack of the Diphtheria organism.
This method is called the Schick test. If the person tested is
found to be susceptible, then a further step can be taken of
definitely treating such person in order to set up a condition
of immunity to the disease. This definite preventive method
is being largely introduced in America, and is beginning to
be recognised in this country. Some large centres, notably
Edinburgh and Birmingham, also the Metropolitan Borough of
Holborn, are acting on these lines, and I propose to bring the
matter to the notice of this Council suggesting that we should
set up similar machinery during the current year.
Dr. E. H. Thomson, M.B., C.M., D.P.H., Medical
Superintendent at the North-Eastern Hospital states:—
"We too often hear about the marked reduction in the
diphtheria mortality rate since the introduction of antidiphtheric
serum. But it is not the extent to which the
mortality has diminished that is remarkable, for every case
can be cured, but that it is still so high. Much avoidable