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care committees and the proceeds, after deducting the cost of materials are given
to the patients. There is a total of 12 such classes in operation in London, with an
average roll of about 18 members at each class.
Report on the Work of the Bacteriological Laboratory.
The work of the bacteriological laboratory during 1930 may be conveniently
divided under the following headings :—
(1) Diphtheria investigations (mainly in schools).
Cultures from a total of 6,840 throat and nose swabbings of 6,268 individuals,
chiefly school children, with a few cases of ear discharge were examined and
reported on. They yielded 836 positive results showing the presence of
micro-organisms morphologically indistinguishable from the diphtheria bacillus,
including 215 which proved positive on re-examination—the net result being 621
positive results or 9.9 per cent, of those originally swabbed—including 7 cases of
ear discharge. In 290 doubtful or negative cultures, a further re-incubation for
24 hours was given and yielded 36 (12.4 per cent.) in which positive results were
obtained.
There was therefore an inclusive total of 7,130 bacteriological examinations of
both throat and nose cultures. In 51 cases, cultures were examined at the Southern
Group Laboratory for virulence by animal inoculation and for confirmation of doubtful
results. Nineteen were returned as virulent, and 11 as avirulent diphtheria bacilli.
In 8 cases the diphtheria bacillus was not verified and in 13 case3 B. Hoffmann only
was identified.
Compared with 1929, there were nearly 1,300 more throat and nose swabbings
from over 1,130 more individuals in 1930.
(2) Throat examinations of maternity nurses for the presence of streptococcus hcemolyticus.
Seventy cultures on blood agar were examined from 53 midwives or maternity
nurses who were contacts of cases of puerperal pyrexia, as compared with
35 examinations from 24 nurses in 1929. Of the 53 nurses, 5 showed streptococci
of the true haemolytic type—i.e., just under 10 per cent.—a proportion which has
been stated to occur normally in any chance group of individuals.
(3) Cerebrospinal fluid.
Examination was made of 135 specimens, for help in diagnosis of . 127 hospital
patients including 49 at the Fulham Hospital, 44 at St. James' Hospital, 21 at
Highgate and 13 at St. Pancras Hospitals, compared with 103 in 1929.
As the result of examination, or of the subsequent course of the cases, the
specimens reported on fall within the following groups:—
(A) Meningitis.—56 specimens from 52 cases :—
(1) Tuberculous.—30 specimens from 28 cases. Tubercle bacilli were found in
16 specimens.
(2) Meningococcal.—13 specimens from 11 cases. The meningococcus was
obtained in culture from 4, and identified in films from the cell deposit in 13 specimens.
(3) Pneumococcal.—In 5 specimens, the pneumococcus was found in culture
and film preparation.
(4) Streptococcal.—Streptococcus was obtained in film preparations, and in
culture in 5 cases, and was associated in 3 cases with cerebral or cerebellar abscess.
(5) Influenzal.—B. influenzae was isolated in culture, in 2 cases, as well as
in film preparations from the cell deposit.
(6) Staphylococcus pyogenes aureus, associated with cerebral abscess secondary
to suppurative parotitis, was obtained in 1 case, in culture and film preparations.
(7) Serous meningitis.—In 3 cases no organisms were found in film preparation
from the fluid, or in culture, but the examination showed evidence of meningeal
reaction, with increase of the cell and protein content—in association with pneumonia
or other acute febrile condition.