View report page

39
From personal observations made when visiting
the homes of many cases, it is clear that in by far
the majority of instances where a disease such as
scarlet fever occurs, home isolation is, strictly
speaking, impossible in the smaller tenements. It
must be remembered that the inhabitants, almost
without exception, are too poor to be able to afford
skilled attendants, the result being that the patient
is attended by a member of the family, usually the
mother, who also looks after the rest of the family,
cooking dinners, etc. On several occasions the
use of a special garment has been advised, as also
the washing of hands before going to other duties,
but, with the best intentions, it is impracticable to
ensure that the full precautions necessary will be
taken. The presence of a staircase used by
several families resident in one house adds a further
element of danger to the spread of disease.
Considering all these facts, it appears to be
desirable that all cases of certain disease, such as
scarlet fever, should be removed to hospital where
more than one family occupy the house; but that,
as regards other diseases, such as enteric fever, the
need of hospital isolation is not so pressing under
such circumstances. So long as there is a sufficiency
of accommodation available, hospital treatment
ought to be offered to all patients of the first
class, and even pressed as far as persuasion will go,
but that in time of pressure preference must of
D 2