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137
At Guy's Hospital clinic 115 children had been dealt with up to 31st December,
1927. Of these, 56 were able to return to school in less than four weeks, 32 in four
to eight weeks, 13 in eight to twelve weeks, 9 in twelve to sixteen weeks, and one
child was under treatment for nineteen weeks, but this case was complicated by
chorea and the child was admitted to a Poor Law hospital. The remainder were
still under treatment. There is no doubt that the existence of this clinic has satisfied
a long-felt want and that much benefit has been derived from the special treatment
of the children concerned and the minimising of risk of spread from such cases.
But the clinic only serves a circumscribed area in South-east London, and more of
these clinics are required in other parts of London if this important problem is to
be properly faced. With this object in view the Council has authorised the extension
of the scheme of treating diphtheria carriers in special clinics attached to certain
other general hospitals in order that the facilities shall be available over a wider
area, and negotiations to this end are proceeding.
Schick test
and active
immunisatioi
against
diphtheria.
The Council has had under consideration from time to time during the past
few years the subject of the Schick test and active immunisation against diphtheria,
and references to this preventive measure has appeared in previous annual reports.
The most recent evidence on the subject is contained in a report, published in March,
1927, by the Medical Research Council, by Dr. J. Graham Forbes, one of the principal
assistant medical officers of the Council. The Medical Research Council, in a preface
to this report, state that it contained a comprehensive survey of this method of
diphtheria prevention practised upon a large scale for the past ten years in America,
and to a much less, though growing, extent in Great Britain.
In July, 1927, it was referred to the Public Health Committee to report as
to the need for taking fresh measures to combat diphtheria, in view of the aforementioned
evidence published by the Medical Research Council, and the following
extract from the report of the Public Health Committee, submitted to the Council
on 20th November, 1927, which was adopted, is quoted in full, as it indicates what
attitude the Council is taking at present with regard to the question of active
immunisation, especially in relation to school children.
In the report the subject is dealt with under main heads as follows:—
"(1) Evidence available with regard to the value of the Schick test and active immunisation
against diphtheria.—The results of his (Dr. Forbes') enquiry show
unmistakably that diphtheria in London has a higher rate of incidence and of
mortality than in almost any other European capital, and a higher rate of both than in
any other large city in Great Britain. The large body of evidence already available
leaves no doubt that the disease and its often fatal consequences may now fairly
be called avoidable. The experience already gained during recent years and in so
many places imposes upon every public health authority the responsibility of
giving serious consideration to the provision of means now available for protecting
life, and especially young life, from the menace of a disease whose prevalence and
malignancy have been increasing of late years, and seem more likely to increase
still further under present conditions than to diminish. At the same time, it should
not be overlooked that an important part of this provision is the necessity for making
the facts clearly known to all parents, and for instructing them as to the means
open to them for the safeguarding of their children." In his report for 1925, the
chief medical officer of the Ministry of Health says:—
"For several years careful observation has been made of the use of the Schick test
and of immunisation against diphtheria. ... As a result of improvement in
material and technique, this method of prevention has now passed beyond the
experimental stage, and is widely regarded as the best way of protecting against
this disease. In my annual report for 1924 its appropriate use was advocated
and local education authorities, hospital authorities and those in charge of maternity
and child welfare centres were recommended to consider its adoption in suitable