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Seventeen cases were traceable to children attending Brompton
School, some being in Westminster, others in adjoining Boroughs.
Examination was made of the children in the Junior Class which was
affected, and several children with suspicious throats were excluded;
some old trough closets were done away with, and proper accommodation
provided.
Bacteriological examination was made, at the Council's expense, in
102 instances. In 24 the results were positive, in 78 negative (but in
5 of the latter a pseudo-diphtheria germ was found). In 21 instances
the examination was made of material taken from persons who had
been in contact with actual cases (not including those examined by
Dr. Kerr at Brompton School); in two instances the organism was
found. In one of these the Metropolitan Asylums Board bacteriologist
was subsequently unable to find that the organism was pathogenic
to animals, and so the patient was sent home together with hexsister
who had been sent independently from a general hospital,
to the fever hospital. Considerable difficulty appears to exist with
reference to the diagnosis of diphtheria. A patient may yield pure
cultures of the organism one day, and for several days, even two
or three weeks after, they cannot be discovered; after a day or two
at home they may turn up again. Fortunately, this is not the usual
course, but the sudden disappearance of organisms in many cases
doubless leads to the statement being made when the patient is sent
from hospital, that he had not been found to be suffering from
diphtheria, and the Metropolitan Asylums Board chronicle it in their
Annual Report as a case of "mistaken diagnosis." Both the medical
man and the medical officer of the hospital in the case mentioned above
had acted properly, in notifying the children as suffering from
diphtheria. It does not appear to be a general rule in the Board's
hospitals to examine discharges from the noses and throats bacteriologically
before sending them home, and in one instance a child came home,
and a few days afterwards her mother was found to be suffering from
diphtheria. The child was then sent on to friends at Acton, where the
Medical Officer of Health at my request saw her, and had examined by
the Lister Institute swabbings from the nose and throat; that from the