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85
CASES OF MISTAKEN DIAGNOSIS OF
INFECTIOUS DISEASES.
(Special Report presented to the Council on November 10th, 1905.)
From the Annual Report, 1904, of the Statistical Committee
of the Metropolitan Asylums Board, it appears that
1,993 patients, a percentage on the total admissions of 10.7,
were, after admission at the Fever Hospital, found not to
be suffering from the diseases mentioned in the notification
certificates upon which they were removed to hospital. The
total percentage may be sub-divided as follows: Scarlet
Fever, 6.7 per cent.; Diphtheria, 16.1 per cent.; Enteric
(Typhoid) Fever, 25.9 per cent.
The difficulties in correctly diagnosing infectious diseases
are, at times, considerable, as is well known to all medical
experts. Indeed, it may be stated, that the more experienced
the medical experts, the greater the difficulty at times
in arriving at a correct diagnosis—at least without careful
and prolonged observation of the patients. The ordinary
conditions under which the large majority of cases have to
be diagnosed are such (e.g., crowded, if not overcrowded,
dirty tenements with but little light) as to render a careful
and prolonged observation impracticable, and certainly, under
the particular circumstances, undesirable. The quicker a
patient suffering from infectious disease is removed from a
crowded, or overcrowed, centre, the better, as the experience
gained in all epidemics shows. The Medical Practitioner
called in to a patient must act quickly upon his judgment
if the interests of the public health are to be studied;
any delay in acting may have disastrous results as far as
spreading of the disease is concerned. The responsibility
must legally lie with the Medical Pract tioner notifying—he
(or she) receiving the fee allowed by law. The question is
one that has again and again been before the Local Government
Board, whose views may be stated as follows:—
1. It is no part of the duty of the Medical Officer of
Health as such to make a personal examination of
patients notified.