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I should like to emphasize the fact that a negative result in the
case of Sputum is by no means sufficient evidence to warrant the
conclusion that Tubercle Bacilli are absent; it not infrequently
happens that five or six examinations niust be made before the
Bacilli can be demonstrated.
In addition to the above, I made several Wasserman tests,
Blood counts, estimation of Hæmoglobin, examination of pus, urine,
etc., for various organisms, such as gonococci, B. Coli Communis,
etc., etc.
Although the general opinion is that Hoffman's Bacillus is not
pathogenic, I must confess that I look upon it with the greatest
amount of suspicion, and 1 do not allow any child shewing it to
return to school until two consecutive swabs taken at about one
week's interval proved Negative.
The following excerpt, "A Diphtheria Carrier,'' from the
Sanitary Record for February 19th, 1915 is most interesting:—
THE SANITARY RECORD.
February 19th, 1915. Page 157.
"A DIPHTHERIA CARRIER."
Dr. Hamer states that the "facilities" afforded by the existence
of a laboratory as part of the public health organisation have proved
to be of great value in arriving at an accurate diagnosis as to the
cause of illness in scholars"—an opinion which will be endorsed by
Medical Officers generally. In this section an interesting account
is given of a "chronic intermittent carrier of diphtheria germs,"
known by the initials of R.C. This girl was referred to in the
report for 1912, and she is still in one of the Metropolitan Asylums
Board Hospitals, where she was admitted in June 1912.
She has grown quite sturdy. A number of methods of
treatment for the elimination of the Klebs-Loeffler bacillus from
the child's throat and nose have been tried, but cultures from her
throat still exhibit the diphtheria bacilli, which on several occasions
have proved virulent or partially so.
The methods tried have been:—Segregation with thorough
feeding and regular hygiene of nose and throat; inoculation with
an autogenous vaccine of twenty-four hours' growth; spraying and
swabbing with various antiseptics: spraying and swabbing with broth
cultures of staphyloccus pyogenes aureus; and lastly, swabbing and
spraying with protargol, a silver compound, so strongly recommended
in carrier cases of cerebro-spinal fever. The complete enucleation
of the tonsils and removal of adenoids have been found efficacious in
many cases. ' R.C.', has not much tonsillar tissue, but it would
appear to be worth while to remove this, and the consent of her
parents is being sought for this purpose." It is not difficult to
imagine the interest this case has aroused in medical circles.