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the street ventilators, and a shaft ventilator against a house was found
to he quite hot to the touch. Legal proceedings in connection with
this are reported below (p. 52).
Bacteriological Diagnosis.—The arrangements made with the Lister
(late Jenner) Institute for bacteriological examination was taken
advantage of with regard to 47 persons who were suffering from throat
affection, or had been exposed to infection; but many other examinations
were made at hospitals and in private laboratories. The bacillus of
diphtheria was found 10 times; in 36 the result was negative, and in 1
case a few suspicious organisms were found. An instructive case was that
of a boy who had been under treatment at a hospital for what appeared
to be follicular tonsillitis (" ulcerated sore throat"), but a swabbing
having been made of the affected part, and submitted to the bacteriologist
of the hospital, showed the presence of diphtheria organisms, whereupon
the case was notified to me; but the mother of the patient being
dissatisfied with this, called in another medical man, who, without the
assistance of a bacteriological examination, pronounced the complaint
not to be diphtheria. The result of a second examination showed that
the hospital authorities had been right, and demonstrated the danger
which was not apparent to the naked eye. Had the case not been
recognised through this means, the boy might have been a source of
infection to others.
The danger was unfortunately exemplified in connection with a
small outbreak which occurred in connection with an infant class in
St. George's Schools. The first case was notified as scarlet fever on
1st October, but on admission to hospital it was found to be diphtheria;
a second case was not discovered by the medical man in attendance to
be diphtheria until the 6th, when the patient was moribund. Five cases
then occurred, and I communicated with Dr. Kerr of the Education
Department of the London County Council, asking him to examine all
the children in the infant class in which these were members. This
was done, and a bacteriological test was made, with the result that
several other children were detected as suffering from the complaint,
some of them with only very slight symptoms, but which were
nevertheless capable of conveying infection to others; thus a child who
was in this class and who had a slight sore throat, which had not been
bad enough to require medical attention, gave the complaint to her
mother. The children in this class were examined a few days later, and
as a result of these examinations all suspicious cases were eliminated,
and no further trouble occurred. The rooms, passages, cloak rooms
&c., were thoroughly disinfected.
It was thought by many parents that the school should have been
closed; but the method adopted in this case has the advantage of causing