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hospital whilst the stools or urine are still infective, from containing the
bacillus typhosus, the Medical Officer of Health of the borough in which
the discharged patient resides, would undertake to send monthly to
Dr. Ledingham, of the Lister Institute, a sample of stools and a sample
of urine during the first six months after discharge from hospital. If the
results, on examination of these samples, should all prove negative,
monthly samples need no longer be sent; but a sample of both stools and
urine should be sent at the end of the next period of six months. If these
also prove negative, no more samples to be sent. This scheme has since
been extended to include all enteric fever patients discharged from M.A.B.
hospitals.
During the year one patient—a female, 5 years of age—was notified
on discharge from hospital as still showing the bacillus typhosus in the
stools. Two subsequent monthly examinations of the stools gave
negative results, and the patient then left Chelsea to reside in Fulham,
the Medical Officer of Health of that Borough being duly informed.
The object of the scheme is to ascertain what proportion of enteric
fever patients subsequent to recovery from the disease continue to discharge
the infective agent in their excreta, and for what periods of time
such infectivity may be prolonged. Incidentally the research should
throw some light on the capacity of these " chronic carriers " to originate
enteric fever either sporadically or in epidemics.
Removals to Hospitals.—Table XVIII. exhibits the removals of
patients suffering from scarlet fever, diphtheria, and enteric fever, to the
M.A.B. and other hospitals, in each of the 20 years, 1890—1909, expressed
as percentages of the total number of cases of each disease notified.