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31
Diphtheria.
Thirty-two cases were notified, and two deaths
occurred.
How many of these 32 cases were true Diphtheria it
is impossible to say. Even if a swab is taken and
submitted to a bacteriological examination it does not
always help one, as we know that the Klebs-Lœffler
bacillus is occasionally found in perfectly healthy throats.
And, again, cases that clinically are not diphtheria
sometimes show that they have been true Diphtheria by
the development of diphtheritic paralysis. There is
no doubt, however, that a great number of cases are
notified as Diphtheria which are only lacunar tonsillitis,
or more often what is termed croupous tonsillitis, when a
false membrane forms on the tonsil.
It has been suggested that the term Diphtheria
should be employed in a clinical sense to include all
affections characterised by the presence of false membranes,
their pathological distinction being indicated by
such terms as staphylococcal, streptococcal, mixed
lœffflerial, pure lœfferial, &c.
Since the introduction of anti-toxin this terrible
disease has been shorn of much of its terrors. If injected
on the first day of the disease the mortality is nil, and
even if the patient has not got Diphtheria it can do no
harm. During the year I have had ample proof of the
value of Diphtheria anti-toxin as a prophylactic. I have
injected 1 c.c. or 16 minims into children who have been
playing with and in contact with others suffering from a
virulent form of the disease, and have never known a child
who has had a prophylactic dose develop the disease. I
now always make it a routine practice to give this small
dose to every child in the house, on condition I get the
parents' consent.
I take this opportunity to again remind the general
practitioners in this district that I keep a supply of