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-as far as possible, its spread, and I am satisfied that the
extra means of prevention offered by bacteriological examination
and diagnosis will, if tried, be found satisfactory.
I suggest, therefore, that facilities should be given to the
Medical men of Lambeth for the Bacteriological Examinations
(free of cost) of discharges, or membranes, from the
throats of patients presumably suffering from Diphtheria, or
suffering from doubtful forms of throat disease, which may
prove of an infectious nature. Much will, of course, depend
upon the Medical Practitioners of Lambeth, and the good
results that will accrue from the above-mentioned extra preventive
measures, will be in proportion to the use they (the
Medical Practitioners) make of them. The matter should
be left entirely in the hands of the Medical profession, and
there should, of course, be no interference on behalf of the
Vestry or its advisers, between patients and Medical Attendants,
except in the cases where the Medical Officer is called
in in consultation.
In addition to Diphtheria cases, doubtful Typhoid Fever,
Cholera, and Tuberculosis cases could also be examined
bacteriologically in the same way, should the Medical
Attendants or others so desire; and such examinations
would prove of great value in deciding definitely the nature
of the illness. It is admitted by all that Typhoid Fever and
Tuberculosis present, at times, very great difficulties in
diagnosis, more especially in the early stages, so that it is
of importance to lessen errors of diagnosis and at the same
time to ensure (as may be required) earlier isolation.
Cholera, fortunateiy, is a rare disease in London, but it is
necessary at times to decide whether a case of severe
Diarrhoea is due to Asiatic Cholera or to ordinary English
Cholera.
The plan suggested is a simple and inexpensive one:—
Each Medical man in Lambeth should be supplied with a
small box—"Diagnosis Outfit" as it is called—containing
sterilised tubes, some furnished with swabs of cotton wool,
and others with pipettes. The Medical Attendant, in
the case of a patient about whose throat disease there is
doubt, would collect, under suitable precautions, a sample,
or samples, of the discharge or membrane, or, in a doubtful
Typhoid patient, a drop or two of blood, place them in the