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30
cleanliness, asepsis and absence of disease in the
horse.
When antitoxic serum is injected into a patient
with diphtheria it produces passive immunity.
The immunity is passive because the patient
takes no active part in the production of the
antitoxin but merely receives it ready made. I
may say that the Public Health Department of
the Borough Council has for many years provided
antitoxic serum free of charge to doctors.
Antitoxic serum is used almost exclusively for
the treatment of diphtheria but is sometimes
employed also for prophylaxis or prevention in
the case of child contacts.
Notwithstanding all the measures described
above and the laborious efforts of public health
authorities to control and eradicate diphtheria,
the number of cases notified remains high. The
number of cases in Fulham during the last five
years, including 1933, was 1,359. The number of
deaths in Fulham during the last five years,
including 1933, was 56, giving a case mortality of
4.12 per cent.
Diphtheria, however, is a preventable disease,
and the mortality should be nil. In plain words
the disease should be entirely eradicated from our
midst. How then is this to be done?
Immunisation against Diphtheria. In April,
1927, I submitted a report to the Public Health
Committee in which I recommended the establishment
of a clinic for immunisation against diphtheria.
Since then I have submitted further reports; the
last report was presented on 13th November, 1933
and was favourably received by the Public Health
Committee and I am very pleased to say that
the Council, on the recommendation of the Committee,
agreed to establish a clinic for the purpose,