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.

    19/34 (page 17)
    received any expression of agreement or disagreement from the medical attendant should not be included in our esti- mates. Such an objection is easily overcome. After ex- cluding those cases there remain still 207 reports, regarding which we have a definite opinion from the medical men. Out of these we have, on one side, 14 cases of unmistakable dis- agreement and, on the other side, 89 positive cases and 104 negative cases in which our finding was clearly accepted or proved to be correct at the fever hospital. According to this estimate the clinical doubts would not be less than 50 per cent., whilst the bacteriological errors would not be more than 7 per cent. It is not necessary for me to push these remarks further to prove my point, but I may add that at least ten of the cases in which no diphtheria bacilli could be found turned out after admission at the Monsall Hospital to be cases of scarlet fever, two of typhoid fever, and one of thrush. I give these only as examples of the difficulties of ordinary diagnosis and to show that although I have accepted as possible cases of error on my side fourteen cases (in which the clinical diagnosis of diphtheria was upheld by the medical man notwithstanding our not finding diphtheria bacilli), it is more than probable that I have und6r-estimated the accuracy of the bacteriological work. I should say that whenever we were at all dissatisfied with the swabs sent to the laboratory, either because they did not seem to have been well loaded with morbid products or contained few or no cultivable bacilli (probably owing to the action of antiseptic applications), we invariably requested that another sample should be sent. I may also add that in several cases of re- examination we obtained in the second and sometimes in the third examination the same results as in the first, showing that the method was applied with sufficient care to ensure constancy of results. There are many interesting points in connexion with the practical effects of the utilisation of bacteriological diagnosis which I must reserve for a further communication by Dr. Niven and myself. IV. Typhoid Fbvbb. The method of diagnosis I use in the case of typhoid fever differs entirely from those I have described in con- nexion with tuberculosis and diphtheria. Here it is not for the bacillus we look but for a peculiar property acquired by the blood of patients affected with typhoid fever. This blood, when brought in contact with living and active cultures of the typhoid bacillus, paralyses the bacilli and causes them to run together and form clumps; the two phenomena of immobilisation and agglomeration constitute the typhoid reaction first described by Widal at the end of the month of June, 1896. Immediately on hearing of this