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work, and these wards are to be built, so there will,
at least, be some real benefit accruing.
Diphtheria.—Seven cases in all were notified
during the year, but in none was any cause ascertained
with certainty. The diagnosis in every
instance was confirmed by bacteriological examination.
In three cases sanitary defects, defective drainage,
were found and remedied. One case was
clearly imported from outside, arriving here on a
visit with premonitory symptoms and from a private
school ''where they had had several cases of sore
throat during the latter part of the term." All the
patients were removed to the Isolation Hospital.
Fortunately we have escaped any outbreak, but in
view of the protean changes in the type of the disease,
an epidemic may arise almost, as it were, suddenly.
One case, the only one, of these seven terminated
fatally ; she was the only child in the family and was
removed to the hospital when her condition became
suspicious, but, had not this case been early put under
strict isolation and observation, for which due credit
should be given to the medicalmen under whose care she
was, irreparable mischief might have been occasioned.
Diphtheria can and does offer cases in every grade,
from the mildest unrecognised and unrecognisable
(except by the expert bacteriologist) type to the most
virulent. It is to the mild unrecognised " ambulatory
cases "that spread of the disease is chiefly
responsible, and it is marvellous that we are ever
free from it in its worst forms. The theory that
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