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that his immunity was insufficient to withstand a massive infection and
that his symptoms were aggravated by an unfortunate delay in his
removal to hospital. Two others were removed to hospital -diagnosed
as diphtheria. One showed no symptoms and had a negative swab in
hospital, the other had a positive swab and slight nasal discharge, which
cleared up at once after a small dose of antitoxin. As these last two
cases were definitely infected but suffered no ill effects, they should be
regarded as satisfactory. The Schick treatment does nothing to prevent
a patient from becoming a " carrier " and only aims at protecting him
from the consequences of the disease.
Parents reported several cases where a protected child was in contact
with the disease, but did not develop it. There is, of course, no definite
proof that infection occurred.
Another child was sent to hospital as diphtheria a few weeks after
Schick treatment. The treatment does not have its full effect for several
months, so such cases are possible. In this particular case, however, the
diagnosis was not confirmed in hospital.
Ian S. Thomson.
Antitoxin, for use in cases of diphtheria, is provided free of charge
for medical practitioners attending patients residing in the City. The
supply is available on application at the City Hall, and at the Council's
Mortuary in Ilorseferry Road. It is apparent from the small amount
used (36 bulbs, each containing 8,000 units), that practitioners prefer
to send their patients at once into the fever hospitals, where antitoxin
is administered on admission to all cases of clinical diphtheria. In
times of epidemic, however, when the capacity of the fever hospitals is
greatly taxed, there tends to be delay in admitting cases, and it is then
that practitioners make full use of the antitoxin supplied by the Council.
Bacteriological Diagnosis.— Swabs from suspected cases among
those residing in the City may be examined by the Council's bacteriologist
free of charge to the practitioners attending. The materials for swabbing
are supplied by the Council, and reports are in the first instance telephoned
or telegraphed to the doctor concerned, and written reports follow. The
number of throat swabs examined by the Council's bacteriologist during
each year since 1924, was:—
1924. 1925. 1926. 1927. 1928.
556 674 679 595 646
Enteric Fever.—There were 28 cases of typhoid and paratyphoid
which came to the knowledge of the department during 1928. Of these
19 were notified as paratyphoid and 9 as typhoid. There was a history
of fish having being consumed in 3 cases, cream 3 cases, ice-cream in