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apparently recovered, but there are, however, many cases which are
at the other extreme, and yield readily to treatment, and it is probable
that this was so in a considerable proportion of the 11 cases returned
from hospital as not suffering from this disease; most of these were
out-patients at general hospitals, and had their throats examined
bacteriologically there. By the time the report was ready and the
cases admitted into an isolation hospital, the treatment under which
they had been put proved sufficient to remove the cause of the disease,
and thus a second examination proved them not to be then suffering.
It has been found in families in which a case occurs that, not
infrequently, other members get the diphtheria organism in their throats,
and may or may not develop symptoms according to their susceptibility
and the state of their health; but if they do not develop symptoms
they may pass the organism on to other persons. If diphtheria is to be
got rid of, it will be necessary to examine children and others in affected
families, especially in tenement houses, so that they may not go about
spreading the disease.
The throat after scarlet fever is in a condition specially adapted for
the growth of the diphtheria organism, and a number of cases occur in
which diphtheria supervenes thereon, but several cases point to the
possibility of scarlet fever patients conveying the diphtheria bacillus in
their throats to other persons, without themselves developing the
disease. Bacteriological examination was made of the throats of two
patients returned home from hospitals as well, but in neither was the
diphtheria organism found ; in one case there was a suspicion that the
infection had been conveyed to other children, in the other the examination
was made as the child was being admitted to an institution.
Attention having been drawn to the fact that discharges from the ears
after scarlet fever might form suitable soil for the growth of diphtheria
bacilli, a look out was kept for such cases, with the result' that one
child was found who, although apparently well on leaving hospital,
developed a discharge from the ear within a day or two. Examination
was made of this discharge, and the report was that it contained
modified forms of the diphtheria bacillus, and on the same day on which
the report was received a sister was found to be suffering from
diphtheria, which rather confirmed the bacteriological report.
In only eleven houses was there more than one case notified, and all
were confined to members of the family attacked. In one house there
were four cases, in another three cases, and in nine houses two in each;
except in four instances (in the last group) they were all notified at the
same time. These four exceptions have certain noteworthy features:—
Group (a) case, notified in January, and was in hospital until August; a
playmate had scarlet fever in the country, and was considered " not to
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