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suspicious cases, and for some years past the Council have paid for such examinations performed
at the Lister Institute on behalf of Kensington patients.
Sterile swabs are obtained from the Town Hall, and, in order to reduce the interval which
occurs from the time the doctor takes the swab to the time he obtains the result, arrangements
have been made for medical men to leave inoculated swabs at the North Kensington Tuberculosis
Dispensary, 119, Ladbroke Grove, before 3.30 p.m., or at the Town Hall, before 4 p.m., on any day
(Saturdays, Sundays and Bank Holidays excepted). Swabs so left are collected by one of the
Council's messengers, who delivers them at the Lister Institute before 5 p.m. on the same day, and
the results are telephoned to the doctors on the following morning. On Saturdays, Sundays and
Bank Holidays medical men can send swabs direct to the Lister Institute before 5 p.m. and obtain
an equally speedy result.
This scheme enables medical men to learn the result of the swab examination 24 or more hours
before the answer could be obtained under the old arrangement, and it has proved of inestimable
value to doctors and their patients.
During the year 579 throat swabs were examined at the Lister Institute at the expense of the
Council, and of these 89 gave a positive diphtheria result.
It is well recognised by the medical profession that the early administration of anti-toxin not
only reduces the mortality from diphtheria, but causes the disease to run a milder and shorter
course; further, by lessening the duration of the patient's infectivity to others, it reduces the period
of occupation of a bed in an isolation hospital.
Under the Anti-toxin Order, 1910, Local Authorities are empowered to supply diphtheria
anti-toxin to medical men for administration to those of their patients who ace unable to pay for
a supply.
With a view to enabling every medical practitioner to administer subcutaneously an adequate
dose of anti-toxin as soon as on clinical evidence he has diagnosed diphtheria in a Kensington
resident who is unable to pay for medical services or anti-toxin, the Council during the year
revised their scheme for the supply of this preparation and have approved the following
arrangements:—
(a) On signing the necessary declaration that the patient is unable to pay for specific
treatment, a medical man can obtain anti-toxin free of cost from:—
(1) Mr. Worsley, Chemist, No. 135, Ladbroke Grove, W. 10. (Anti-toxin can
be obtained at this address during the day or night).
(2) The Medical Officer of Health, Town Hall, W. 8. During office hours
application should be made at the Public Health Department and at
other times to Mr. Sutton, an officer of the Department, who lives at
No. 1. Hornton Place, Hornton Street, (only a few yards from the
Town Hall).
(b) On application to Mr. Worsley, or the Medical Officer of Health, a medical man can
obtain free of cost the loan of an anti-toxin syringe and portable sterilizer. (The
syringe should be sterilized and returned together with the sterilizer immediately
after use. It must be clearly understood that the medical practitioner must satisfy
himself in regard to the sterilization of the syringe before use and that the Council
cannot accept any responsibility whatever in this matter).
(c) Medical practitioners administering the Council's anti-toxin to poor persons who
cannot afford to pay an adequate fee will, on application to the Medical Officer of
Health, be paid a lee of 5s. per patient in respect of the medical assistance
rendered by them.
Experience has shown that for the purposes of treatment it is seldom safe practice to rely on
any dose which is less than 8,000 units, whatever the age of the patient may be. As a means of
simplifying the use of the serum for treatment, the Council have decided to stock diphtheria antitoxin
only in phials which contain 8,000 units. This amount of anti-toxin is in concentrated form,
and a curative dose can be given in one injection with a 10 c.cm. syringe.
In addition to making the above arrangements the Council have authorised me to keep a
number of phials each containing 500 units of anti-toxin for prophylactic use in the case of persons
who have been in close contact with a patient suffering from diphtheria. These prophylactic doses
are stocked in the Public Health Department of the Town Hall and also at my private address
(No. 9, The Triangle, W. 10. Telephone No. Park 1524).
The Council are prepared to pay a fee of 5s. for the administration of a prophylactic dose of
their anti-toxin in the case of a patient who is unable to pay for medical assistance, provided that
they are satisfied that such administration is desirable in the interests of Public Health.
In 1922 the Borough Council supplied 66,000 units of anti-toxin for 19 patients at a cost of
£5 10s. Od. During the year the fees claimed by medical practitioners totalled 15s.
Enteric Fever—Eighteen cases of this disease were notified, 16 being removed to hospital.
The cases notified in the three preceding years were 16, 24 and 22. There were two deaths from
this cause against 2, 1 and 3 in the preceding years. Ten of the 18 cases were notified from
North Kensington and 8 from South Kensington. In four cases the disease was contracted on
the Continent, and in two cases there was a suspicion that fried fish was the vehicle by which
contagion had been conveyed. One case was notified as para-typhoid fever.