A study of the foregoing tables will show a difference in the number of specimens sent to the Laboratory of Bacteriology from different counties. The variations in this number are not altogether a result of different size or population of the respective counties, but rather depend upon the number of physicians in each county who make use of this Laboratory. It is to be remembered, however, that in Allen and Marion Counties the principal cities, Ft. Wayne and Indianapolis, have laboratories of their own. We have tried during the two years since this Laboratory was created, to reach every physician in Indiana and invite his cooperation in the crusade against infectious diseases. The results have been especially satisfactory where we could meet the doctors personally and discuss the means which are best adapted to the needs of their respective communities. To meet the physicians personally, while it brings the best results and will do most to reduce the extent and frequency of epidemics in this State, has been made nearly impossible because of the limited number of employes in the Bacteriological Laboratory. If one of the number goes out to investigate an epidemic or to attend a medical meeting. the others must do more work than would tend toward accuracy. The character of the work done in this department is wholly different from that of any other line of business because in the majority of specimens submitted the life of the patient depends on the thoroughness with which the microscopical examination is conducted, the correctness of the diagnosis and speed with which results are reported to the physicians. The tables of diphtheria by counties reveal a peculiar situation, the significance of which is of economic importance to this State. We refer to the fact that many counties are credited with more positives, i. e., specimens containing diphtheria bacilli, than those in which these bacteria were absent. This means that the health officers release patients from quarantine without making the attempt to determine with absolute certainty that the Klebs-Loeffler bacilli, which are the specific cause of diphtheria, have really disappeared from the nose and throat of every member of the infected household. This is a great mistake because we know that no one can tell merely by looking at a throat whether or not it contains Klebs-Loeffler bacilli. It is folly to suppose that every person in whose nose and throat these bacteria have found lodgment must necessarily develop the clinical symptoms of diphtheria. Physicians are too prone to consider a patient safe to be at large as soon as the inflammatory symptoms have subsided, and con stantly endanger their communities by releasing families from quarantine too early. There are several ways in which the State Laboratory of Bacteriology may help to solve the problem confronting the State of Indiana with regard to the prevention of infectious diseases. They are: 1. To communicate with every registered physician in this State and supply him with all the necessary outfits and instructions, when and how to send the specimens. 2. To have members of this department meet the physicians at their town and county societies to discuss the ways and means which will be best adapted to prevent infectious diseases in their localities. 3. To assist in the examination of school children in the public schools of any town or city, except such as have their own laboratories, immediately upon the detection of a case of diphtheria in a school. 4. To help in the education of the general public by occasional public demonstrations and exhibits of such character as will teach people to understand the nature of infectious diseases, their specific effects on the human body, and the best ways to prevent infection, the value of quarantine, etc. Such exhibits will be of use, not only to the laity, but also to the physicians and especially the health officers. When people realize that it is the infectious disease which the State Board of Health desires to put in quarantine and that all persons who have become the carriers of infection, regardless of the fact that they may apparently be in perfect health, must be prevented from spreading the disease. |