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xvi.
throats of all the children in the School bacteriologically, but this would
have to be done of all the children who had been in the same class or
the same room as the patient. This would not be so big a matter as it
appears. With the help of the teacher of the class from 25 to 30 swabs
can be taken in an hour without difficulty.
Each swab would be labelled with the name or number of the child
from whom it was taken, and cultures would be made from it which would
be labelled in the same way. In 24 hours or so the result of the examination
would be complete, and almost all the infected children would be known,
and would be excluded from the Schools under observation. The chief
practical difficulty is what to do with these excluded children. One or two
would perhaps develop the disease in the ordinary way, and would be removed to
Hospital on the first signs of it. The greater number would remain perfectly
well, but still dangerous to others, and repeated examinations would have to
be made of their throats till they were found to be free from the bacillus.
Unfortunately no means are at present known of destroying the bacillus
in situ, but by daily application of some antiseptic the danger of the bacillus
escaping and infecting others is greatly reduced, if not entirely prevented.
Possibly some arrangement might be made for the suspicious children to
attend daily at some convenient place for this treatment instead of going
to School, but in all probability the total number of such children would be
very small.
All the bacteriological work in connection with Diphtheria could be
carried out in a Laboratory that has been provided in the new Council House.
The expense would be small compared to the importance of the work, and
it would be easy to divide the share of the cost of the Laboratory to be
paid for by the Education Committee. It would at most amount to a few
pounds a year after the preliminary purchase of apparatus.
So much for the three chief divisions of the duties of the Medical Officer.
I will only refer to one other that he might well undertake, and that is
the medical examination of all candidates for appointments as teachers under
the Committee.