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existence of infectious disease in any house the Inspector
immediately visits the house, leaves a paper of "Precautions
to be taken in cases of infectious disease," gives
directions as to the isolation of the patient, and advises
where necessary how best this may be carried out.
Unfortunately these precautions, directions, and advice
are too commonly honoured in the breach than
observance. Subsequent notifications and visits show
that other members of the family, especially the
children, are allowed freely to associate with the patient,
with the direct result that multiple cases in a house are
the rule and single cases the exception. Nor, indeed,
can any other course be expected, particularly in the
Winter months, when the resources of many families are
at the lowest ebb, and climatic conditions render it
impossible to keep the healthy members of the family
very largely out of doors. Absence of available means
of home isolation is aggravated by our
5. WANT OF SUFFICIENT HOSPITAL ACCOMMODATION.
The present number of beds in the Fever
Hospital available for diphtheria is 36. During the
nine months ended 30th September, 1899, 240 cases of
diphtheria were received into the hospital. Several of
these cases were admitted from East Ham, frequently
in a condition of extreme gravity, so that considerably
less than 25 per cent, of the diphtheria cases notified
were able to be removed to hospital. It is difficult to
put into words the piteous appeals for removal to our
hospital, the surprised looks on receiving information
that the beds are all occupied, and the sometimes forcible
language at the present inability to provide sufficient
accommodation which the members of your Public
Health Staff constantly encounter. There can be little
doubt that a great deal of preventible diphtheria has