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January 28, 1911

Bacteriologic vs. Clinical Control of Diphtheria Quarantine

Author Affiliations

Corpus Christi, Tex. Health Officer Nueces County.

JAMA. 1911;LVI(4):288. doi:10.1001/jama.1911.02560040056030

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To the Editor:  —Dr. Simonds in his article on diphtheria (The Journal, Jan. 7, 1910, p. 37) said: "It is evidently unjust to... the patient... to place him in quarantine on a clinical diagnosis of diphtheria, which in over 40 per cent, of the cases is proved by bacteriologic examination to be incorrect."It seems to me that this is assuming an infallibility for bacteriologists that is unwarranted. No careful and experienced physician would consider even half a dozen bacteriologic examinations as proof of error in a case diagnosed as diphtheria from clinical evidence such as the presence of a membrane and a rise of temperature. Negative evidence must always be uncertain, and, while a positive diagnosis based on bacteriologic examination should be taken as conclusive even where the clinical evidence is negative, it does not follow that the reverse is true. In other words, the presence of the characteristic

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