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cases of the disease, the City Council have made arrangements whereby
a supply of anti-toxin may be available for the use of medical
practitioners, in cases in which the patients (resident in Westminster)
are themselves unable to pay, and I enclose particulars of these
arrangements.
"In this connection I may remind you that if the best results are to
be obtained, anti-toxin must be administered within the first forty-eight
hours. Dr. Goodall, Medical Superintendent ol Homerton Fever
Hospital, in a paper read recently before the Medical Officers of Health
Society, stated that he had never seen paralysis ensue if anti-toxin had
been given within that period; that the earlier anti-toxin is given, the
smaller is the dose required. He advised that in suspected cases, where
the probability is strong, anti-toxin should be given, especially where
the patient is under ten years of age. In cases in which the patient is
being removed promptly to hospital, Dr. Goodall does not consider it of
much advantage to administer a dose of anti-toxin before removal, but
it should be used if delay in removal to hospital is inevitable. Dr.
Goodall further pointed out that the use of anti-toxin is contraindicated
in patients suffering from asthma or allied disorders, or if
more than a week had elapsed since the previous dose was administered,
as dangerous and even fatal results had followed its use under such
circumstances.
"The Local Government Board wish it to be understood that the free
provision of diphtheria anti-toxin must not be regarded as a substitute
for the removal to hospital of a patient suffering from diphtheria, or as
implying that the patient to whom anti-toxin has been administered
may properly be retained for treatment at home unless means are available
for his efficient isolation to the satisfaction of the Medical Officer
of Health.
"The Westminster City Council have made arrangements that
medical practitioners practising in Westminster can obtain a supply of
diphtheria anti-toxin (4,000 units) for poor patients resident in Westminster,
at the following places and times :—
"(1) Messrs. Parke, Davis & Co., Beak Street, Kegent Street, W.
(Telephone Nos. 8636 Gerrard and 9201 Central; Telegraphic Address—
"Cascara,"London).
Monday to Friday inclusive—9 a.m. to 8 p.m.
Saturdays—9 a.m. to 1 p.m. and 6 p.m. to 7 p.m.
Sundays and Bank Holidays —11 a.m. to 12 noon and
7 p.m. to 8 p.m.
"(2) Messrs. Heppell & Co. Chemists, of 35, Hayniarket and
78, Strand. At any hour of the day and night, except on Sunday night
between midnight and 8 a.m. on Monday.