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alone is found, but to treat and consider all these cases
as coming under the generic team of Diphtheria.
It is interesting to note that the infective condition
in patients who either have the true or pseudo bacillus
of Diphtheria has been prolonged owing to the existence
of decayed teeth, and in many cases where I have been
able to remove the teeth the bacilli have very rapidly
disappeared. During the year it was noted that in 73
per cent. of the cases of Diphtheria decayed teeth were
found to be present.
No case is discharged from the Hospital until such
time as all congestion of the throat or fauces has disappeared,
or where there has been any cough or any
discharge, such patient is not considered free from
infection until cured ol these sequelas, as well as the
absence of either of the bacilli associated with the
disease on two swabbings on following days.
In attempting to trace outbreaks of Diphtheria
during the last few years, I have been struck with the
large number of cases which have occurred as a result
of infection from a primary case which has not been
recognised, nor has the individual even been appreciably
unwell, but in whom I have discovered in many
instances either the bacillus of Diphtheria or the
existence of some one or other of the nervous sequelae
associated with an attack of Diphtheria, and that, in
addition to the usual forms of paralysis, that there
have been dilations of the pupils, which do not react
readily to light; this dilation of pupils I find
existing in a large number of cases sent in to the Hospital
for treatment in the earlier stages of disease. It cannot