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16
SANITARY CHRONICLES, 1895.
writer, and in about 24 hours after the receipt a Report is
obtained from the Institute of Preventive Medicine as to
whether the diphtheria bacillus has been identified or not.
A great number of the medical men now send the boxes
in before notifying, and if the case is not found to be
diphtheria, no notification, of course, follows. The expense
of enquiry is as follows: The fee charged by the Institute is
2s. 6d , the box costs a penny, the test-tubes, bought by the
gross, about one penny and a halfpenny, and the cost of
sterilising, supplying the tubes with the wires, and wool,
another penny, the postage is three halfpence, which brings
the cost up to 2s. lid. per case. There are also, occasionally,
some other trifling expenses, so that it will be right to say
that this system costs about 3s. per case. On the other
hand, since the majority of medical men now do not
notify until after such an examination, a good many false
cases of diphtheria which would otherwise be notified, and
the statutory half-crown paid, are, of course, not notified;
besides which, there must be included the great advantage
from an economical point of view, in not sending a patient
with an ordinary sore throat, however diphtheritic it may
look, to hospital, where he is kept for some time at the
expense of the rates. It is too early yet to speak decidedly
about the success of this measure, but, so far, it looks most
promising.
Since October, when the Vestry adopted the writer's
suggestion, many cases which would otherwise have been
kept at home and spread the malady, have been removed to
hospital and conversely, many patients which would have
been sent to hospital, have been treated at home, because
the primary diagnosis has not been confirmed: those cases
which have been dealt with at home under the presumption
that they were not true diphtheria showed no inclination to
spread, and the patients have recovered without showing the
rather common sequelfe of paralysis or kidney mischief,
which tends to show that the bacteriological diagnosis was
the correct one.
TYPHOID FEVER.
Typhoid fever showed a decided increase. The average
number for five years of typhoid cases is 108, but last year