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38
Hamer, in a paper before the Epidemological Society, stated
that " if the Klebs-Loeffler Bacillus be regarded as a 'secondary
invader,' the difficulties experienced in differentiating between
the Klebs-Loeffler Bacillus and closely related non-pathogenic
or feebly pathogenic forms having a wide distribution and
very commonly met with in healthy mucous membranes, cease
to have any serious significance. It is easy to understand how
it happens that, provided the soil is once prepared, whether by
some unknown specific organism or by a specific 'ferment,'
the widely distributed ' secondary invader' finds scope for its
development, and the well-known bacteriological phenomena
associated with an attack of Diphtheria intervene. Under
other conditions, the same cause of disease, operating for the
most part not with the Klebs-Loeffler Bacillus, but with
streptococei or with other bacteria, brings about an outbreak
of Scarlet Fever. On such an hypothesis the well-known
tendency to interchangeability of the two diseases may
perhaps find explanation; it would apparently be necessary to
assume that the nature of the malady set up in an individual
becoming the subject of throat affection would largely be
determined by the character of the organisms already present
in his throat and capable of taking up the role of "secondary
invaders.'"
The view generally held, though, is that the two diseases
are not interchangeable, and the more careful the inquiries the
more distinct the two diseases seemed to be. The "carrier"
theory seemed to fit more easily to the facts. Cases of
Diphtheria crop up in different districts at intervals until a
" missed " case is detected, when the outbreak immediately
ceases. Instances were given in last year's report of such outbreaks
in Valetta Road and The Avenue. A somewhat
similar instance occurred in The Steyne in July 1909'. Four
cases were reported, the last of whom had had "sore throat "
for over three weeks. No further cases resulted after the
removal of the latter case to the Hospital.