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24 hours. At no time did the child exhibit any clinical signs other
than the positive swab results. Her throat swab was still positive
15.7.36; tonsils and adenoids were removed 21.7.36 and all swabs
taken after 30.7.36 were negative. She was discharged 7.8.36, after
34 days in hospital, fit and well. In this child, while sufficient
time had not elapsed to allow of a full degree of immunity being
obtained, the treatment did, in view of the positive Virulence Test
and the complete absence of clinical symptoms, afford the child a
considerable degree of protection.
A third child, aged 5 years, developed a mild attack of Diphtheria,
subsequent to a negative Schick reaction after treatment at
the Clinic. History was as follows:—Received 3 injections of 1.0 cc
T.A.M., one week elapsing between injections. Schick Tested at
8 weeks, he proved to be Schick positive, and received 2 further
injections of 1.0 cc, at an interval of a fortnight. After a long wait
of 13 months owing to intercurrent illness, he gave a Schick negative
reaction on 31.3.36. On 7.9.36 he complained of sore throat,
and was found to have a small patch of membrane on one tonsil;
swab positive ; removed to hospital 9.9.36, having had 16,000 units
of antitoxin before admission. Swabs continued to remain positive
until 2.10.36, but apart from a persistent sore on the lip, convalescence
was uneventful and he was discharged well on 17.10.36.
Defaulters.—Of 16 children who failed to complete treatment,
11 left the district before completion (8 having had full course of 3
injections but no retest), 1 died following an operation before due
for retest, and 4 discontinued attendance (3 having had 3 injections,
and one 1 injection only).
Not Completed at End of Year.—Six hundred and eight whose
treatment is at various stages have been carried over to 1937.
Summary.—There is sufficient demand, as shown by the numbers
on the waiting list, to justify the continuance of the Clinic.
The relative absence of defaulters and the satisfactory results
in regard to (a) immunity developed, (b) small percentage of
fractions, suggest that the work should be continued on the present
lines: further that, in view of the lack of certainty in results of
"one shot immunisation," and the fact that two shot treatment
with A.P.T. has not been sufficiently employed as yet to allow of
a reliable comparison of results, it would be unwise, meantime, to
"lake any change.