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Parish of St. George the Martyr, Southwark.
METHODS OF COLLECTING SPECIMENS.
The plan usually followed is to provide every medical man in the district with
outfits suited for both the foregoing purposes.
COST.
The total cost of the laboratory examination varies from 2s. 6d. to 3s. 6d., the
latter price being authorised at St. Pancras. To the above amounts must be
added the original cost of outfit and the postage to and from the Health Department.
It should be borne in mind, however, in considering the question of cost, that the
method is needed only in doubtful cases.
HOW FAR IS THE BACTERIOLOGICAL METHOD PRACTISED?
St. Pancras and St. Olave's adopt the plan both for diphtheria and for typhoid
fever, and, so far as can be ascertained, are the only Sanitary Authorities in London
which follow that course.
For diphtheria alone the public test is applied in St. Marylebone, Holborn and
Strand, while Camberwell has made arrangements to do the same shortly at a cost of
four shillings per case. Poplar has a similar course under serious consideration.
From Mr. Murphy's London County Council Report for 1896, wo learn that in St.
Marylebono, material from 87 cases was examined with positive results in 46; in
Holborn 17 with the like result in 10. This gives a decision in the affirmative of
over fifty per cent. in 104 presumably doubtful cases to which the test was applied.
It should be noted that the bacteriological method of diagnosing diphthoria has
been carried out for some years past in many provincial districts, notably in Bristol,
Brighton, Manchester, and Liverpool. In some of them tho typhoid fever test has
also been instituted. The pioneers in this extremely practical departure in public
health work hail from America.
My own conclusions upon this important subject may be briefly indicated as
follows:—
1. That it is of great value from a practical standpoint to detect diphthoria and
typhoid fever with certainty, especially in the early and late stages. In both cases
tho method may be now and then essential in the prevention of the spread of the
disease.
2. That the benefit will be both individual and general: (1) Individual, in tho
determination of doubtful cases, and of the proper course of treatment, and in saving
him from unnecessary exposure. (2) General (a), in the detection of cases, and ho of
indicating the need of isolation and disinfection; (6) in preventing uncured cases in
children from returning to school, and there becoming fresh centres of infection.
3. That the possibility of such detection is now rendered scientifically cortain
by means of a bacteriological examination of the secretions of diphtheria, and of the
blood of patients suffering from typhoid fever.
4. That the actual cost to the Vestry would be small in comparison with tho
gain to patients and the prevention of the spread of disease.
5. That, so far as I have been able to learn, the exporienco of those Sanitary
Authorities who have adopted the tests has been satisfactory, although perhaps
medical men have not availed themselves of the proffered opportunities so generally
as had been anticipated.
That, in my opinion, the adoption of both tests would be of distinct value to
the sanitary administration of tho District of St. George the Martyr.
8th March, 1898.