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The cost of treatment is borne by the Metropolitan Asylums Board, but certain
cases are assessed and the amount collected as contributions, less a small charge
for the expenses incurred in collecting, is handed over to the Board. This arrangement
has been in force since September, 1924. Up to 31st December, 1926, 59
cases have been sent to Carshalton for treatment. Steps have been taken to bring
these facilities to the notice of the surgical staff of all Voluntary Hospitals in London,
with a view to ensuring that cases are recommended for treatment while in the early
stages of the disease.
Report on the Diagnostic and other work of the Bacteriological Laboratory.
During 1926 a total of 11,125 specimens of material sent for bacteriological,
microscopical or bio-chemical report were examined, as compared with 10,710 in 1925.
In addition, special investigations included :—
(a) Milk.—A full inquiry as to the cleanliness and bacterial content,
chemical analysis and microscopical examination of 68 samples of milk supplied
to the Claybury Mental Hospital—the subject of a detailed report to the
Hospital Committee on 19th April, 1926.
(b) Swimming-bath Water.—Quantitative bacteriological examinations were
made of 42 samples of water from the four swimming baths at Peckham Park,
Highbury Fields, Tooting and Southwark Park, taken in the course of ten visits
paid during the months of July, August and September, for the purpose ef comparing
the degree of bacterial pollution of water treated by filtration, chlorination
and aeration in the baths supplied with the special plant of the Turnover Filter
Company at Peckham Park and Highbury Fields, with that of untreated water
contained in the baths at Tooting and Southwark Park, where renewal of water
is the only means of removing bacterial impurity. The comparison from the
bacteriological standpoint was entirely in favour of the use of the filter plant.
Particulars were included in a combined chemical and bacteriological report
made to the Parks Committee (No. 416) on 28th January, 1927.
To meet the requirements of all the bacteriological work involved, a total of
close on 11,000 tubes of serum and other media and over 80 plates of various culture
media (a larger number than in any previous year) were prepared by the two
laboratory assistants.
imary of I. Diphtheria.—A total of 9,039 cultures from throat and nose swabs, over 1,000
,lne more than in any previous year (in 1925, 7,910), were examined, yielding 766 or
s. 1 8-5 per cent, in which the diphtheria bacillus was found, 22 or -3 per cent, reported
as " suspicious," and 8,251, or 91-2 per cent, negative results. The average number
of cultures examined daily amounted to close on 29, and the largest number in one
single day, 105 ; in one month (December), 1,304.
These examinations were the outcome of 433 visits during the year, paid by
school doctors or nurses to separate departments of 233 schools, in the course of
which some 47,000 children were examined (as compared with 43,000 in 1925),
mainly in the boroughs of Southwark, Bermondsey, Camberwell, Deptford and
Wandsworth, south of the river; Islington in the north, and Bethnal Green and
Stepney in the east end. In all, 569 new " carriers " of the diphtheria bacillus were
identified bacteriologically in 1926.
In addition, the importance of ascertaining the virulence of diphtheria cultures
from certain selected chronic carriers among the school children, involved the work
of obtaining the diphtheria bacillus in pure growth by repeated sub-culture, in 110
cases. Of the pure cultures, thus isolated and sent to the Clinical Research Association
for the necessary animal inoculation tests, 73, an unusually high proportion,
were reported virulent and 37 avirulent. In the case of the latter, known to be
harmless and incapable of causing clinical diphtheria, it was therefore safe to allow