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1ll
three such mild cases, in which I confirmed the suspicion of
Diphtheria being present. In one of these a brother had a
suspicious throat six weeks ago.
Many of these doubtful cases might be cleared up, and the
spread of infection prevented, if medical practitioners had the
means of obtaining a bacteriological examination of the
patient's throat. This is provided for now by many Sanitary
authorities in London and the Provinces; among others, in
Bristol, Holborn, St. Pancras, New York, &c. In these places,
any doubtful case is examined at the outset, for determining if
Diphtheria is or is not present, and all cases are examined at
the termination, to discover if the disease has ceased to be
infectious.
My recommendation that arrangements should be made by
which this could be done for Plumstead, was approved by the
Health Committee, but, unfortunately, it was found that the
Plumstead Vestry had no power to spend money for such an
object. This is very much to be regretted, for obviously such
expenditure of money would directly and materially assist in
the prevention of one of the most fatal diseases with which the
Vestry has to deal.
27. The period when a case of Diphtheria ceases to be
infectious is very uncertain, and appears to vary from 3 or 4
weeks to 6 or 7 months. It is generally considered that when
a bacteriological examination cannot be obtained, at least six
weeks should expire before a case can be regarded as free from
infection. Case3 often appear to be quite well, however, much
sooner than this, and at the urgent request of parents medical
men commonly give their sanction to a cessation of isolation
after the lapse of 2 or 3 weeks; they argue sometimes that it
would be useless to attempt to procure a longer isolation when