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diseases co-existed. In the event of co-existent diseases, they could be treated in the cubicle until
well; while in the event of it turning out to be the disease for which it was sent to the hospital, the
patient could be drafted after a certain time into a suitable common ward where the cases were
classified. Another set of cubicles would provide isolation rooms for all patients suffering from
discharges, thus preventing any possibility of spreading to other cases, and avoiding the danger of
remaining in a ward in which infectious material could be engrafted on the discharges. In this
manner some of the advantages of the cubicle system could be secured in hospitals already built.
In this way the stay of patients in hospital could be still further reduced to the advantage of
the patients, the parents, the public generally and the ratepayers, and " return" cases would be
abolished or reduced to a minimum.
DIPHTHERIA.
The number of cases of diphtheria notified was only 53, of which 22 belonged to St. Giles and
Bloomsbury and 31 to the Holborn Sub-district. All but 9 were removed to hospital. The decennial
average for the Borough was 144 ; 53 for St. Giles and Bloomsbury and 91 for the Holborn district.
The mortality in the two divisions was very different, viz., 22.7 in Bloomsbury and only 6'5 in the
Holborn division. There was no special outbreak during the year, the largest number of cases notified
in any one week having been only 4.
Secondary and " Return " Cases.
During the early part of January there were three nurses at the Children's Hospital attacked
with diphtheria, and one nurse had also recently contracted enteric fever from nursing an enteric
patient. I therefore saw the Resident Medical Officer and was glad to find that he was preparing a
new set of rules and precautions for nurses who had to attend infections cases, and made some
suggestions respecting the same.
The only "return" cases occurred at one house in the Borough. The first patient, a male
four and a-half years, was admitted to the North- Western Hospital on February 5th, suffering from
scarlet fever. The patient suffered from post-scarlatinal diphtheria, and was notified on the 13th
March and returned home on April 11th. On the 21st April, I had information that there was
infectious disease at this house. On making inquiries I found that the mother and the aunt of the
child who had returned from hospital had also suffered from sore throat, and each of them had some
exudation of the fauces but no typical membrane. I saw the doctor who attended the cases, and took
him two diphtheria outfits as I was of opinion that they were most probably suffering from diphtheria.
On the 23rd the reports of the bacteriological examinations were received, and in each case the
diphtheria bacilli were found, and the patients were notified and removed to hospital. The aunt
returned to another house on the 15th May, and the mother returned home on the 19th May. On
the 22nd May I had notification of the fourth case at the house, a male of six years; he, however,
did not belong to the same family.
In the remaining 45 houses there was only one case in each with no spread of infection.
ENTERIC AND CONTINUED FEVER.
Including two cases of continued fever, which were most probably enteric, as they were notified
at the same time as a case of typhoid fever in the same house, apparently from the same source of
infection, 56 cases were notified, of which 38 belonged to St. Giles and Bloomsbury, and 18 to the
Holborn District. The decennial average being 51 for the Borough, and 26 and 25 respectively for
the two divisions. 45 of the 56 cases were removed to hospital, and two of them were returned not
enteric fever, also two other cases which were not removed to hospital, I was of opinion were not
enteric fever.
The notifications month by month were 3, 3, 1, 5, 2, 2, 1, 2, 5, 4, 4, 24.
It is thus seen that only 16 of the cases occurred in the first six months of the year, and that
there was rather a large outbreak of the disease in the month of December.