SEANCE DU 16 NOVEMBRE 999 



disease and présent lésions which will remain slight or run a course 

 like normal diphtheria. 



Ancient carriers on the other hand are found in contaminated areas 

 where diphtheria has been witnessed for a long time. Thèse ancient 

 carriers hâve a normal throat, their mucous membrane seem to be 

 healthy and they do not catch diphtheria. Schick's method shows that 

 they présent a certain immunily ; thèse carriers probably hâve been 

 immunized by a smallattack. They can spread the disease. They are 

 ofteu called healthy carriers. 



Carriers are sometimes very numerous in familles affected with diph- 

 theria where fifty per cent of carriers and more are seen. 



In coliectivities leading a very homely life with very numerous, 

 direct contacts, and if the fîrst cases of diphtheria has not been isolated 

 the number of carriers are often as high as ten per cent. If précaution 

 is taken at the outbreak of the fîrst cases it is only from two to five 

 per cent. 



In large coliectivities such as the army the number of carriers is 

 generally inferior to ten per cent. 



Hère are a few figures for which we are indebted to Ihe kindness of 

 our colleague Guyénot; 



There has been an epidemy for several weeks in a camp of 4,978 men. 

 As diphtheria existed in ail the units spécimens of mucus were taken 

 from every man at the rate of 500 per day. Cultures were performed 

 wilh a swab and after a fîrst examination ail men were kept who had 

 proved to be carriers of bacilli coloured by the Gram method. 



Five hundred and eighty six suspects were found among whom 

 176 with long bacilli. They were isolated; but the carriers of long 

 bacilli were separated from those of short bacilli. 



This happened from the 7lh to 20th of July, 1916. On the lOth of 

 AuguHt there remained only 29 carriers of diphtheric bacilli. On Lhe 

 13th of September, 27 remained, on loth of October 11, and on loth of 

 November 4. 



Two among the latter remained carriers of bacilli for more than a 

 year. 



Out of 113 convalescents examined during this period there remained 

 only nine carriers on September Ist. There was only one on the Ist 

 of December. 



Diphtheria disappeared from lhe camp as soon as the carriers were 

 elimiriated. 



The détection and isolation of carriers in coliectivities of healthy 

 people give the best results; it should be recommended. 



When the disease is localized in a group of individuals it is sufficient 

 to examine the men in the contaminated groups. During the war men 

 had to be taken from contaminated units; this could be done safely 



