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highest 56 in the year 1899. Of the 22 deaths, 8 belonged to Bloomsbury and St. Giles, and 14 to
the Holboro Division. The decennial averages for these divisions of the Borough were 19 and 23
respectively. All the 22 deaths were of young children under 5 years of age. In hot and dry
summers there are many deaths from infantile Diarrhoea, but on account of the cool and wet summer
last year there were only six deaths during the third or summer quarter.
ENGLISH CHOLERA.
On the 24th September, I had information from the Secretary of the British Lying-in
Hospital that for some weeks there had been cases of English cholera at the hospital I therefore
visited the premises and made a very careful enquiry. I found that from the 20th May to the 24th
September, i.e. during a period of seventeen weeks, of the 51 nurses who had, during that time been
engaged at the hospital, as many as 19 had suffered from severe diarrhoea or English cholera.
The matron and two assistant-matrons were also attacked. During this period there were about 180
confinements, but only seven mothers were attacked. The domestic staff consists of a cook and five
housemaids. Within the past six weeks there have been three new housemaids, so that of the nine
members of the domestic staff only the cook was attacked.
On the 8th June the new home for the nurses was opened. I found the drainage, sanitary
conveniences and water supply satisfactory. On the other hand the larder is in a very unsatisfactory
position. It is a basement room adjoining Short's Gardens, and is so placed that dust and dirt from
the street can easily be blown on to any milk or other food that is placed there.
Many outbreaks of diarrhœa in hospitals have been traced to the milk supply, and it has been
shown that even milk that has been cooked, as in baked rice pudding, has not been raised to a
sufficiently high temperature to destroy the spores of the germs (Bacilli enteriditis sporogenes) which
will produce diarrhœa.
The four last cases occurred on the 18th or 19th September. This was a very dry week, there
having been no rainfall on six of the seven days, and no rain at all on the five days previous to this
last outbreak. For about three weeks previously there had been no case of diarrhœa, and the outbreak
preceding this occurred after an interval of dry weather. It is at such times that milk is specially
liable to be contaminated by street dust, which generally contains some of the germs I have mentioned.
After careful inspections and long interviews with the Matron on the 24th and 25th September,
I saw the Secretary on the evening of the 25th, and informed him that from the peculiar nature of
the outbreak I had formed the opinion that the milk supply was the most probable cause, and that it
was desirable that all milk should be boiled, and that no food should be stored in the present larder or
at least not without being kept in a refrigerator.
SEPTIC OR HOSPITAL SORE THROAT.
As there was this year a large increase in the number of cases of septic or hospital sore throat
amongst the staff of the Alexandra Hospital, I was asked by the Secretary to examine the drainage of
the hospital. I had made several inspections of the drainage of this hospital after its rebuilding about
five years ago, and the work was then carried out in a first-class manner.
On making a careful inspection of all the drainage, sanitary conveniences, and accessories in
the hospital, I found that all were in very good order, and that the main drain and manholes were
exceptionally clean. This is probably accounted for by the fact that the drains arc well flushed with
an antiseptic solution every week.
I afterwards made further inspections of the wards and the remainder of the premises with the
Matron and the senior Surgeon, Mr. Bowlby, and after consideration of the matter, sent the following
report:—
Suggestions and Recommendations for the Prevention of Hospital Sore Throat.
(1) The dressings to be well sprayed with water or a solution of disinfectant before being
removed from the patients, and at once placed into water or a solution of disinfectant in order to
prevent any contamination of the bed linen or the air of the wards.