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of diphtheria bacilli. Another returned case was found to
have Hoffman's bacillus.
53. Bacteriological Diagnosis. 1.231 (705 in 1911) swabs
were sent to the Lister Institute to be examined for the
presence of diphtheria bacillus. In 320 (92 in 1911) the true
Klebs Loffler bacillus was found (in 1 of these Hoffman's
bacillus co-existed with the Klebs Loffler bacillus); in 128
(101 in 1911) Hoffman's bacillus was found, and 783 were
found free from either the Klebs Loffler bacillus or Hoffman's.
Of the 1,231 swabs examined, 406 were taken from school
children by myself. Of these, 95 contained the true Klebs
Loffler bacillus (so-called positive cases). Most of these were
contacts seen about ten days after notification of a primary
case for the purpose of preventing pupils returning to school
in an infectious state. Others were examined with the
object of finding possible sources of infection, e.g., where the
first case notified in a house was a child not attending school ;
others again were children suspected to have diphtheria by
the School Teacher, the Attendance Officer or Sanitary
Inspector. In most cases the bacillus had disappeared within
two or three weeks, but in 4 children they were found for over
a month, and in 1 case Klebs Loffler bacillus persisted for
four months, when the child's tonsils were removed and the
bacilli disappeared. The child's education was seriously interfered
with. So far, no satisfactory means has been found of
destroying the germs in carrier cases.
27 positive cases had symptoms of running or sore nose or
sore throat; these were notified and sent to hospital or
strictly isolated. Positive cases without any symptoms were
excluded from school and from mixing with other children
outside the house.