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The Board rely upon your cordial co-operation in giving effect to
these arrangements, and I trust that you will see that no case in which
the diagnosis is clear will be submitted. Either the Medical Officer of
Health or myself will be happy to receive from you any suggestions, as
to how the arrangements may be made most advantageous to the
interests of the public health.
I am Sir,
Your obedient servant,
HENRY C. JONES,
Clerk to the Board.
Bacteriological Examinations in suspected cases
of Diphtheria or Enteric (Typhoid) Fever.
Diphtheria.
Place the patient in a good light. Remove the cotton wadding
stopper from the tube containing the iron wire. Depress the tongue
with a spatula, rub the cotton wadding pledget fixed at the end of the
rod, gently, but firmly, against any visible exudate; or in other cases,
including those in which the exudate is confined to the larynx, pass the
pledget as far back as possible, rub it firmly against the mucous membranes
of the pharnyx and tonsils.
Still keeping the wire in one hand, withdraw the stopper from the
tube containing the solidified blood serum, then rub the pledget once or
twice over the surface of the serum, taking care not to break the
surface in any way. Replace the plug, and then return the wire rod
with its pledget to its tube, which also should be re-stoppered at once.
Label the serum tube.
Pack the two tubes in the box, taking care to put a little wadding
at each end.
Enteric Fever.
To obtain the blood for diagnostic purposes from a typhoid fever
patient, the best plan is to wash the lobe of the ear, or the back of the
finger just below the nail, very thoroughly, first with soap and water,
and then with any antiseptic solution that is handy, or, better still,
after washing, allow a cloth soaked in a weak solution of an antiseptic
to remain on the part until dry; then wash thoroughly with absolute