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34
I have always replied to such complaints that it is not advisable to
adopt the practice of sending cases to hospital, or even of certifying them,
as Diphtheria simply on a bacteriological examination, for if we do we
shall often lay ourselves open, and rightly so, to severe blame.
The mere presence of the true diphtheria bacillus in the throat
signifies very little by itself, as we know it is often to be found in the
throat of persons in perfect health. Likewise the "negative" result of
the examination of a swab says very little in the face of a distinct patch
of "membrane" being on the throat.
Therefore the most obvious symptom is the membrane. If that in
present we can certainly say the case is one of Diphtheria, whilst the
absence of any distinct membrane during the progress of the case, should
incline us to consider it as not of the true disease.
ENTERIC FEVER.
The deaths from Euteric Fever during the year 1902 numbered 23.
as against 18 for the preceding year.
The total number of cases notified was 193 for the present year, as
against 135 for 1901.
The percentage of deaths to the total cases notified was 11.9.
The annual mortality per 1,000 living was .11.
Deaths from Enteric Fever for the last ten years:—
1893 29 1898 20
1894 21 1899 32
1895 23 1900 39
1896 26 1901 18
1897 21 1902 23
Of the 193 cases notified, as many as 179 were removed to hospital,
with 20 deaths, a mortality of ll.l per cent.
14 cases were treated at home with three deaths, a mortality of 21.4
per cent.
The percentage of cases removed to hospital to the total number
notified was 92.7.