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23
In my Annual Report for the year 1903, I suggested various means that I was of
opinion would reduce the number of "Return" cases and reduce the length of the
stay of patients in hospitals. I emphasised the importance of every infectious hospital
being well supplied with small isolation wards, that general wards for scarlet fever,
diphtheria and measles should, if possible, be small rather than large so as to lessen
the risk of the spread of other infectious diseases accidentally introduced. In fact that
fever hospitals should be constructed so as to secure isolation as far as possible. I
mentioned that the ideal system of hospital construction, viz., the cubicle system exists
at the Pasteur Hospital, Paris, which is in connection with the Pasteur Institute. Even
this hospital, however, is not wholly ideal, for on each floor, in addition to 12 cubicles
there is also a common ward containing 12 beds for convalescents.
In March, 1904, Dr. Louis Martin, resident physician of the Pasteur Hospital,
published a paper in Le Bulletin Medical, giving details of the structure of the
hospital, and the study of 2,000 consecutive cases treated at the hospital. From the
1st October, 1900, to the 17th April, 1903, the 2,000 patients received at the hospital
were:—
524 Small-pox.
55 Chicken-pox.
443 Diphtheria.
166 Non-diphtheritic throat affections.
126 Measles.
92 Scarlet fever.
163 Erysipelas.
20 Tonsilitis.
7 Rabies.
26 Anti-rabies treatment.
7 Preventive anti-diphtheritic treatment.
192 Mothers of sick childrea or children of sick mothers.
179 Other illnesses not included under the above headings.
Although the convalescents are treated in wards containing twelve beds, and
more than one-fourth of the patients were suffering from small-pox, infection was
conveyed to other patients in only six cases, viz., 4 small-pox and 2 erysipelas—i.e.,
only 3 per 1,000.
At the time of Dr. Martin's report, 745 fresh patients had been received, and
there had been only two new infections, viz., one small-pox and one convalescent from
scarlet fever had contracted diphtheria. Therefore, of 2,745 admissions infection was
conveyed in less than 3 per 1,000.
From the Annual Reports of the Metropolitan Asylums Board for five years, 1900
to 1904 inclusive, of a total of 61,245 scarlet fever admissions, as many as 4,800 also
suffered from other infectious diseases during their stay in hospital—i.e., rather more
than 78 per 1,000.