The bacteriological diagnosis of certain infectious diseases in connexion with public health work / by Sheridan Delépine.

  • Delépine, Sheridan, 1855-1921.
Date:
[1898]
Catalogue details

Licence: Public Domain Mark

Credit: The bacteriological diagnosis of certain infectious diseases in connexion with public health work / by Sheridan Delépine. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    18/34 (page 16)
    detected. In 271 no diphtheria bacilli were found. In 4 cases doubtful results were obtained and were reported as such. Bo that in 390 cases out of 394—i.e., in very nearly 99 per cent, of the cases—definite results, either positive or negative, were obtained. Regarding the amount of agreement observed between the laboratory results and the further clinical study of the cases I have been able through Dr. Niven's kindness to obtain the following information concerning the Manchester cases. 311 specimens taken from Manchester patients were examined ; in 89 of these diphtheria bacilli were found and as the bacteriological diagnosis was invariably accepted nothing need be said about these cases. In 218 no diphtheria bacilli were found. Our negative report was not accepted by the medical attendant in 20 cases. In about half of the remaining cases the medical men wrote in answer to inquiries that they accepted our diagnosis. Regarding tbe other half we could get no information, but we had good reason to believe that if fault had been found with our report this would have been freely expressed, for the medical men were earnestly asked to do so without restraint. Excluding the four doubtful ones there remain 307 cases. Our bacteriological reports were openly accepted in some 188 cases, received without opposition in 99 cases, and challenged in 20 cases. Of these 20, 3 which were admitted in the fever hospital developed scarlet fever; another was seen by Dr. Niven, who satisfied himself that the patient was not suffering from diphtheria; another case had, judging from the history afterwards obtained, scarlet fever and in another case the patient recovered so rapidly that the diagnosis of diphtheria was difficult to support on any clinical ground. Of the 14 cases remaining after these have been excluded 2 seem to have been cases of diphtheria, but in none of the others has the information given us been sufficiently clear to make it certain that from a clinical point of view there was no doubt as to the nature of the illness. If we admit, however, that in 14 cases the bacterio- logical method failed to give accurate information this amounts to saying that in 4 per cent, of the cases on which we reported our opinion was not supported by the course taken by the case. If we compare this result of bacteriological examinations as tested by clinical observation with those of clinical obser- vation as tested by the bacteriological method we find that out of 307 cases suspected of being possibly affected with diph- theria not less than 218 were, bacteriologically, not cases of that disease, or if we exclude the 14 cases just alluded to in which our opinion was openly challenged, without our being able to prove that the error was not on our side, we find that 204 out of 293 cases of suspected diphtheria were affected with some other disease. This means doubt in 69 per cent, of the cases to compare with our 4 per cent, of error. But it might be said that the cases about which we have not