utensils userl in food, such as cups, spoons, etc., may undoubtedly spread the infection.
The fact that by fai- the ^n-eater number of carriers have normal throats, therefore no excessive discliarge from the nose or posterior nasopharynx, and thus little inclination to indulj,'e in spitting, is an additional factor in making such a njethod of spread improbable.
The treatment of convalescent cases, as regards the possibility of their spreading infection, is similar to that of carriers.
There is no reason why positive contacts should not be allowed to take exercise in the open an [)r()vided they are isolated from their fellow-creatures, and care is taken to mark their food utensils.
Prophylaxis. — Prophylaxis for the healthy individual resolves itself into the use of general hygienic measures, especially avoiding cold, catarrhal affections and overcrowding.
In epidemic areas, schools should close, and troo[)s leave barracks for roomy huts or tents in the open air ; provided in each case there is no incidence of the disease nor occurrence of carriers amongst the individuals concerned. The billeting of soldiers upon civilians should cease.
Notes of> Bacteriologist re the Richmond Military Hospital Cases.
(For these Notes, I am indebted to Captaiu M. W. Flack, ll.A.M.C. Bacteriologist at Millbank. )
In the diagnosis of the following four cases, and in the bacteriological examination of their contacts, the Millbank medium, consistinir of trypsinised ox heart broth, to which agar and an extract of pea-flour are subsequently added, has been used throughout — before pouring, 2 per cent, of ordinary horse serum is added. When endeavouring to grow the meningococcus from the cerebro-spinal fluid of the patient, a little fresh human blood is spread over the surface of the medium.
The examination of contacts is performed by swabbing their naso- pharynx (using a West's swab) and plating the swab immediately. The plates are incubated for 24 hours, and suspicious colonies of gram-negative cocci are subcultured on plates. These are incubated for another 24 hours.
