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51
The number of cases of chicken-pox unknown to school-teachers is found to
be about 88 per cent. of the number known to medical practitioners; and of
the total number of cases made known to the Sanitary Authority, only about
14 per cent. do not obtain medical advice, these percentages being the result of
experience in St. Pancras.
When doubtful cases came to be referred to medical referees, the second
medical opinion greatly reduced the chances of mistaken diagnosis, on the one
hand saving households from exposure to infection through small-pox being
mistaken for chicken-pox, and on the other saving many patients from a long
and tedious ambulance journey, with risk of infection through chicken-pox
being mistaken for small-pox. Medical referees do not protect persons other
than medical men from regarding modified small-pox as chicken-pox; but
the fear of prosecution leads to the notification of chicken-pox not medically
attended, and enables proper means to be promptly adopted for ascertaining
its true nature. Hence the notification of chicken-pox when small-pox is
prevalent is of great value in insuring that the utmost care is taken by
patients, or the parents and guardians of patients, as well as by medical
attendants, to make as sure as human skill can that every case of small-pox is
discovered and dealt with promptly.
The number of cases of chicken-pox notified week by week during the
epidemic of small-pox, and the ages of patients, is stated in the tables under
the head of small-pox above.
DIPHTHERIA ANTITOXIN.
A circular letter, asking whether Diphtheria Antitoxin is kept for sale, and
if so, at what hours it is procurable and in what strengths, quantities and
prices, was sent to all the Pharmaceutical Chemists in St. Pancras and certain
agents and producers of Antitoxin outside St. Pancras, in the City, West
Centre, and West End. From the replies it appears that eleven Pharmaceutical
Chemists in different parts of St. Puncras keep Antitoxin in stock, obtainable
at almost any hour, that five Pharmaceutical Chemists who do not keep it in
stock are prepared to obtain it at short notice, and in all probability the
majority of the fifty or more Pharmaceutical Chemists in St. Pancras will be
prepared to obtain it at short notice for any medical man who gives an order.
With regard to the replies from outside St. Pancras, three are original makers,
one is an agent for a Continental maker, one for an American maker, and one
for a London Institution.
Diphtheria Antitoxin may be used as a curative agent in the case of a patient
purposely detained at a home for nursing or unable to be admitted to hospital
on account of lack of a bed. The danger of either of these events is that other
persons, especially children, in the house may become infected and then it
may be advisable to inoculate the healthy children as a precaution to prevent
the disease, and Diphtheria Antitoxin may then be regarded as a preventive,
the duration of its efficacy being reported to be about three weeks, according
to the experience of the Children's Hospitals in Paris.
For curative purposes from 1,000 to 4,000 Behring units of potency may be
inoculated at a dose, the usual number being 2,000 units in 5 cubic centimetres