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disease prevented thereby from spreading from person to person.
A serious outbreak of infectious sore-throats in connection with a
school in Lambeth has been most successfully dealt with recently
by means of bacteriological diagnosis, i.e., by finding out the cases
(some exceedingly mild, and therefore unrecognisable without
Bacteriology). Out of a total of 137 scholars, 57 suspicious
throats were from time to time examined bacteriologically, with
the result that 48 showed the presence of bacilli—4, the KlebsLoeffler
(true Diphtheria) Bacilli and 38 the Hoffman (pseudodiphtheria)
Bacilli. The 4 cases of Diphtheria were at once sent
to the Hospital, whilst the 38 pseudo-patients were isolated in a
special isolation house belonging to the school, but distinct and
away from the main building, and not allowed to return to the
main building until further bacteriological examination of their
throats failed to show the pseudo-Bacilli. This necessitated a
total of 145 Bacteriological examinations and re-examinations.
Only one adult (the porter) was affected out of a total of 28 adults
(teachers and servants) employed in the school.
The sanitary state of the school premises is good, the drains
have been recently re-laid and the sanitary arrangements remodelled
under my own supervision, and in accordance with my
own suggestions, and the outbreak goes to show in a marked degree
that Diphtheria and pseudo-Diphtheria are not necessarily
associated with, or the result of, defective drains and insanitary
conditions.
The preventive measures which I suggested, and which were
strictly carried out by the Medical Attendant, may be mentioned.
The scholars were carefully watched from day to day, suspicious
throats swabbed and examined bacteriologically, and afterwards
isolated, or not, according as such examinations gave positive or
negative results. In this way the whole of the doubtful cases
were separated out, and kept under observation in an isolated
building, where they remained until such time as further bacteriological
examinations shewed the scholars throats to be free from
infection. Then, and not till then, were the scholars gradually
drafted back into the school, after their clothes and persons had
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