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obtained even from typical cases of diphtheria, owing either to the
swab not being taken properly or because only a few diphtheria
organisms have been taken on the swab with many others, which
latter grow luxuriantly on the bacteriological medium and so
greatly overwhelm in numbers the specific organisms which cannot
be seen on microscopic examination. Swabbing is especially
valuable in detecting "carriers" or "missed" cases where there
is no membrane to be seen on the throat or where the nose is involved.
As diphtheria may, in some cases, progress so rapidly that the
patient is soon overwhelmed with the diphtheria toxin it is imperative
that not only should the disease be recognised early but that
anti-toxin should be given at the earliest possible stage of the
disease. To facilitate the early administration of the specific
anti-toxin supplies are available at the Town Hall where they can
be obtained by medical practitioners at any time of the day. In
necessitous cases the anti-toxin is supplied free by the Council.
Fatal results sometimes occur because the parents have delayed
calling in a doctor in the early stages and have only sent for him
when there is little hope. Unfortunately patients in the early
stages often do not show the usual symptoms of acute illness, the
temperature may not be high and the throat may not be very
sore and sometimes it is only after two or three, or even four days'
illness that the doctor is sent for; then the submaxillary glands
are much enlarged and serious complications are likely to follow.
Every opportunity, therefore, is taken to impress upon the parents
the urgent necessity of calling in a doctor in all cases of sore throat.
During the year 52,000 units of anti-toxin were supplied free
of charge for administration by medical practitioners in necessitous
cases.
Scarlet Fever.—The number of cases of scarlet fever was
also the lowest since 1918, 107 cases having been notified. The
distribution of the cases in the months of the year is indicated in
Table VI. It will be seen that the months in which most cases
occurred were February, 15; April, 12; August, 10; November, 11;
and December, 18. The cases, even in these particular months,
were widely scattered throughout the district with little discernible
relationship between them. There was only one death from scarlet