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59
The clinic at the London hospital is under the care of Mr. F. Muecke, who
has reported as follows :—

Dr. A. B. Porteous, who is in charge of the clinic at St. Mary's hospital, has
submitted the following report:—
During the year 1932, 19 cases were referred to the diphtheria carrier clinic of St. Mary's
hospital.
Their ages varied from 3 to 15 years, and they were sent in from the following sources
Paddington, 9 ; Kensington, 5 ; St. Pancras, 3 ; St. Marylebone, 1 ; Hoi born, 1. Twelve of
these cases came through the Council, six from medical officers of health, and one from the
out-patient department of St. Mary's hospital.
The methods of examination and treatment have been as reported last year. Vaccines
have been made use of. In only one case was it necessary to operate on the throat. In one
case the ear was suspect, but this proved negative to the virulence test.
Of the 19 cases, eight failed to show suspicious organisms at their first and subsequent
examinations at this hospital. This seems worthy of comment.
3 had organisms suspicious of K.L.B. in nose only.
4 „ „ „ „ in nose and throat only.
1 „ „ „ „ in throat only.
Twelve virulence tests were done, and of these only two were positive. One of these was a
nose carrier, which was treated with vaccine and cleared up in six weeks. The other had a
membrane on the tonsil and was sent to a fever hospital.
One cannot reach any certain conclusions in regard to such a small number of cases. I still
think that vaccines—autogenous and stock—are useful.
It is interesting to note that of the 11 cases carrying suspicious organisms, 2 cleared up in
two and four weeks, respectively, 7 were proved to be non-virulent and 2 were virulent, 1 clearing
up in four weeks and the other being sent to hospital.
The final result is that with the exception of one child who ceased to attend here but went
elsewhere, and one sent to hospital, all these cases were proved harmless.
Professor John Eyre has furnished the following statement regarding the work
carried out at the special clinic at Guy's hospital:—
The clinic has continued its work during the year 1932 under the charge of Dr. L. W. Cann
(bacteriological department), and Mr. R. J. Cann (throat department), the two medical officers
originally appointed in 1926, who have throughout rendered conspicuously meritorious service
in dealing with the carrier problem. The number of new cases was slightly less than that noted
for the previous year—a diminution probably due to the elimination of " possible " cases by the
application of the virulence test at some " pre-clinic " period. This suggestion derives some
support from our figures, which show that the diphtheria bacillus was recovered from 62 per cent,
of the cases in 1932, as compared with 39 per cent, only in 1931.