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35
"Twenty answers were received. The scheme for arriving at a
correct diagnosis was considered good by all the Practitioners, and
the question of payment for sending membrane and secretions was
raised by some of them.
"There is no doubt that such an examination could be easily
carried out, with the consent of the parents, &c., in the first instance,
upon notification, and the 2s. 6d. fee should satisfy any Practitioner,
who should doubtlessly be paid for his trouble, whether the complaint
turned out to be diphtheria or not; but the difficulty would be in
declaring a patient free, as the services of the Medical Man who
first attended might have been discontinued, so that there might be
no Practitioner in attendance, or another one might have been called
in from a district where the measure was not in operation, so that
this part of the scheme would appear to be unworkable, unless adopted
throughout the Metropolis.
"The matter is a very difficult one to carry out in its entirety.
There is no doubt, as has been pointed out in one of my annual
reports, that a large number of cases notified as being diphtheria are
not the complaint. In one Metropolitan sanitary area, in which
60 cases were bacteriologically examined, it was found that no less
than 24 were not true diphtheria, though all the symptons were those
of the dread disease, so that if bacteriological examinations of
throats were universally carried out, the hardship and expense consequent
upon isolation and disinfection would be saved.
"On the other hand, the Committee will remember that at the end
of the year 1897, when diphtheria was prevalent, with a high
mortality, on the Isle of Dogs, children were found attending the
Wharf Road Board School suffering from complaints following
diphtheria, and they had never been notified as having the
complaint.
"If the aid of bacteriology is to be of any use, doubtlessly all sore
throats should be tested for diphtheria, inasmuch as diphtheria cases