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the so-called "return" cases some had been due to the re-introduction of infection into households owing to the disturbance of
insufficiently disinfected clothes, &c., left at home and stored
away during the patient's stay in hospital.
(b) That it was desirable that those sanitary authorities in the
Metropolitan district who had not then provided themselves with
steam disinfectors should be urged to do so with the least possible
delay, and further, that the authorities who still entrusted the
work of disinfection to contractors should be advised to discontinue
the practice and to have the work carried out by responsible
officials.
Return cases of Scarlet Fever must to some extent necessarily
occur in every district, and we have had examples of these
cases in Bloomburg-street, Ponsonby-place, and Carpenterstreet ; but provided another certificate is supplied the Metropolitan
Asylums Board authorities are quite willing to re-admit
such patients.
Antitoxic Serum Treatment of Diphtheria.
With regard to this treatment during 1895, the Medical
Superintendents of the Metropolitan Asylums Board hospitals
give the following summary of their conclusions:—
(i.) A great reduction in the mortality of cases brought under
treatment on the first and second day of illness;
(ii.) The lowering of the combined general mortality to a point
below that of any former year ;
(iii.) The still more remarkable reduction in the mortality of the
laryngeal cases;
(iv.) The uniform improvement in the results of tracheotomy at
each separate hospital;
(v.) The beneficial effect produced on the clinical course of the
disease.
The medical superintendents conclude by expressing the opinion
" that in antitoxic serum we possess a remedy of distinctly
greater value in the treatment of diphtheria than any other
with which we are acquainted."
Diphtheria and Elementary Schools.
Dr. Smith, in his report upon this subject, issued in April,
1896, by direction of the School Board for London, arrives at
the following conclusions:—
1. That diphtheria has always been more prevalent in the
south-eastern counties of England than elsewhere, and from them
it spread to I.ondon, whilst it still maintained its prevalence in
them, such counties as Staffordshire, Durham, and Lancashire
(the congenial home of most zymotics) being comparatively free.
2. The recrudescence of the disease in 1881-90 was greatest in
England and Wales at the age 2 to 3 years, and in London at the
age 1 to 2 years, in both cases before school age.