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as suffering from the diseases (named), but subsequently found
to be not so suffering." The returns were made by the medical
superintendents who, moreover, were asked to state "What
steps (if any) can be taken to promote the refusal of admission
to, or early discharge from, the hospitals of the Board of all
cases wrongly diagnosed as diphtheria, or as enteric fever."
The replies to the queries were made separately in respect of
each of the diseases by the several medical superintendents,
and are very interesting, but it is unnecessary to cite them,
having regard to the conclusion which the General Purposes
Committee expressed in their report, which reads as follows :—
"Having carefully considered (as directed by the Managers) the facts
connected with the admission into the hospitals of the Managers of
patients certified to be suffering from diphtheria or enteric fever,
but subsequently found to be not so suffering, and having consulted
the Medical Superintendents thereon, we find from the figures for
the years 1895-6, that the danger from infection to the patients so
admitted is very small, whereas the risk of serious consequences
from their refusal, both to the individuals concerned and to the
community at large, would, in the opinion of the Medical Superintendents,
be very great. We are therefore of opinion that no change
should be made in the existing practice of at once admitting all who
are duly certified."
I entertain no doubt that, as a general rule, the conclusion
at which the Committee arrived was the proper one,
having regard to the interests of public health. But questions
may nevertheless arise—Whether the care necessary in the
circumstances is always taken to avoid error, or to ensure
accuracy, in diagnosis?; and whether, if the actual disease is
trivial, the patient should be exposed even to the small risk
attending admission to the hospital? These questions would
admit of something approaching to a correct answer had
the Committee appended to the report a statement of the
actual diseases from which the patients were "afterwards"
found to be suffering. It is an obvious reflection that
the medical superintendent has time to make his diagnosis,
whereas the time at the disposal of the hardly-worked