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100
Report of Medical Officer of Health.
mucous discharges from nose or ear should be rigorously excluded; that immediately
od the appearance of any such discharge the patient should be removed; and that all
nozzles of syringes should be kept in antiseptic solutions. In the other ward no special
attention should be paid to these discharges other than that hitherto adopted. The
incidence of either rhinorrhcea or otorrhcea should be compared. Cases of 'septic
scarlet fever' should be excluded from both.
"(ii.) That, if possible, in certain hospitals, with the approval of the medical superintendents,
two or more rooms previously disinfected be reserved for the isolation, after six or
eight weeks' detention, of single patients who are suffering from rhinorrhcea or
otorrhcea, but whose desquamation is completed. Each patient so secluded should be
kept for ten days or a fortnight before returning home. During this period of detention
the affected parts should be regularly irrigated or syringed with some reliable antiseptic,
and great care should be taken that the nozzle of the apparatus be kept in a germicidal
solution. On the expiration of the quarantine the patient should be sent home
whether the discharge has ceased or not, and the room should be disinfected prior to
the reception of another patient. The subsequent history of the case should be
investigated.
"(iii.) That the inquiry into the facts connected with the incidence of return cases at the
Managers' hospitals should be continued for a further period of twelve months, and
that the scope of the inquiry should include the history of the cases discharged under
the conditions mentioned."
The Asylums Board have authorized the carrying out of recommendations (i.) and (ii.), so far
as can be done without detriment to the efficiency of the hospitals, and have decided to carry out
the third recommendation.
It will he noted that the Board have not accepted Prof. Simpson's suggestion to inform
medical officers of health of discharges of patients to their respective districts. This recommendation
ought to he pressed for, as there is reason to believe that the known "return cases" do not
represent the whole of such cases. It is probable that infection is occasionally spread from recently
discharged patients to those with whom they associate in schools, playgrounds, &c It is, moreover,
desirable for the complete elucidation of the question that information should be collated of the
circumstances under which no such cases occur as well as of those attending their occurrence. This
cannot be done vintil the local medical officers of health are regularly informed of all discharges
from hospital.
At present it has been alleged that the hospital officials do not know to which sanitary areas
the patients go, owing to the overlapping of the boundaries of poor law and sanitary districts.
This overlapping will be removed in consequence of adjustments following the formation of the
municipal areas.
Table of Return Cases, 1900.