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26
In November the following letter was sent to Medical
Practitioners in the Borough :—
"After an interval, in which the occurrence of Diphtheria
has fallen to a comparatively low ebb, we appear, at
the present time, to be confronted with a marked recrudesence
of the disease, but mainly of a mild type.
"But, what is most serious, and, in my experience, quite
unusual, is the prevalence, during the past few weeks,
of a mild type of nasal Diphtheria, without obvious
membrane, and such as would not—in the absence of
other grounds for suspecting an infectious disease—
be regarded as more than an ordinary catarrh.
"The accompanying notes of cases will show you how I
have come to be aware of three such cases, which a
bacteriological examination shewed to be Diphtheria,
and which, I have little doubt, were the cause of
communicating the disease to others.
"It appears that where any such case of clinical Diphtheria
has occurred in a family, any member with the
least discharge or soreness of the nose, is to be regarded
as a possible case of the disease and source of
infection.
"I thought that you would be glad to be made aware of
these facts in case Diphtheria should occur among
your own patients."
42. The following are the notes of the cases above referred
to :—
Case No. 1.—On the 11th of November, I was asked by
Dr.—— to see M. H. W., age 4, S. J. W., age 2,
and H. S. W., age 4, brother and sisters, with a view
to confirming the diagnosis of Diphtheria, before
removal to Hospital. This I had no hesitation in
doing, but, at the same time, I observed a brother,