View report page

33
rooms mentioned in this and the preceding recommendations
to be carefully considered by the Medical
Superintendents.
7. That inquiry into the subject of "return cases" should be
continued, on lines to be suggested by the Medical
Superintendents.
8. That arrangements be made to notify each "return case"
to the superintendent of the hospital from which the
infecting patient was discharged.
The adoption of certain of the above recommendations would
necessitate an increased number of staff, and would also diminish
the accommodation available for the direct admission of cases. We
consider that both these changes are justified by the prospect of
reaching a higher standard of efficiency in the purpose for which the
hospitals are primarily intended, viz., the protection of the public
from infection.
Recommendations of the Board's Medical Superintendent's—
Diphtheria.
Prom the evidence collected by Dr. Cameron, we see that "return
cases" are less common after Diphtheria than after Scarlet Fever;
and that a larger proportion of the alleged cases were doubtful or
proved coincidences. Further, a larger proportion of the Diphtheria
"return cases" must be classed (provisionally, at any rate) as
non-preventible ; since no abnormal condition was detected in the
supposed infectious cases.
We are not prepared to recommend at present any special
systems of isolation even experimentally.
The question whether a bacteriological examination before
discharge gives any additional security should be further investigated.
Diphtheria and Membranous Croup.—During the year 1905
there were 372 cases of diphtheria and 12 cases of membranous
croup notified in the Borough of Hackney. Of these 22 cases of
diphtheria and 1 case of membranous croup were found not to be
suffering from this disease, thus leaving 261 genuine cases of