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primary case had been in hospital seven weeks and had had a slight discharge from
the ears for three days which had however entirely ceased fourteen days before his
leaving the hospital, and there had been no recurrence, and the patient had been in
every way quite well since his return from hospital. He was removed to the fever
hospital from a General Hospital where he had attended as an out patient.
One of the secondary cases mentioned above began to suffer from scarlet fever on
the 51st day, or more than seven weeks after the removal of the primary patient to
hospital. The primary case was not discharged until more than three weeks after this,
but if he had happened to have been discharged from hospital after a stay of seven
weeks or less, this secondary case would also have been considered a "return" case,
although the primary patient in this case would not have been the source of infection.
There was also another secondary case which began to suffer from scarlet fever on
the 37th day or more than five weeks after the removal of the primary patient to
hospital, and the primary case was not returned home until three weeks after the
removal of the secondary case.
Errors in Diagnosis.
During the year three patients were returned from the Metropolitan Asylums
Board Hospitals as not suffering from scarlet fever. One was returned forthwith to
the hospital from which it had been removed ; one after a stay of eight days; and the
third after a stay of 28 days.
As the number of cases notified was 156, the errors of diagnosis were less than
2 per cent., and were less than the general average for the whole of London which in
the year 1904 was 6-7 per cent., and in the year 1903, 7*0 per cent.
The Council desired to ascertain whether a Conference on the subject between the
various Metropolitan Boroughs and the Metropolitan Asylums Board could, with
advantage, be held to discuss the matter, and a suggestion was made that the Medical
Officer of Health should be required to confirm the diagnosis of the Medical Practitioner
in all cases prior to removal.
To this the Metropolitan Asylums Board replied that the following report of the
Hospitals Committee had been approved and adopted by the Board.
Extract from Report op Hospital Committee.
"2nd November, 1905.
"(1) Accommodation of patients.—On the 14th October last, the Board referred
to us for report a letter from the Council of the Metropolitan Borough of Holborn,
dated 18th September, 1905, in which they call attention to an alleged expenditure
amounting, according to their estimate, to about £60,000, which they say has been