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79
Report of Medical, Officer of Health.]
last year on this account was £856, as compared with the amounts set out below for the preceding
six years:—
1894 £875 1897 £1,109
1895 £881 1898 £1,203
1896 £1,284 1899 £947
Proposals for the erection of a disinfecting station have been discussed for some years past. A
site was purchased some three years ago, on a portion of which it was proposed to erect a station,
the preliminary plans of which have been prepared. It is questionable whether it would be possible
to equip and maintain the staff and plant necessary to disinfect and cleanse the goods to the extent
at present in vogue, except at an outlay greatly in excess of what is spent on the work. So
far as is known, no other Authority sends disinfected articles home in a condition almost equal to
new. The new contract has worked satisfactorily, and effected an economy. The total amount paid
in the last twelvemonths (£856) was much below that paid in 1898 (£1,203) under the old
schedule of prices, although the total weight of goods removed last year was only 5½ tons less than
that removed in 1898.
Compulsory Removal to Hospital.—For the first time in the course of some six years
application was made in August last, under Sec. 66 of the Public Health (London) Act, 1891, for an
Order to compel the parents to submit to the removal of their sick child to hospital. The facts
of the case are briefly as follow :—
On August 20th, M. M., female, aged 4 years, was certified to be ill with diphtheria.
The patient's family consisted of father, mother, and 2 children, 1 over 10 years and 1
under (the patient), and resided in the basement (underground) rooms. The whole house
contained 9 rooms, occupied by 5 families, in all comprising 13 individuals, 3 of whom were
under 10 years of age. The father's consent to removal was obtained, but the mother refused
to allow the child to go when the ambulance arrived. Application for an Order for removal
was made on the next day, but the Magistrate would only grant a summons calling upon the
parents to show cause why an Order should not be made. The summons was heard on the
22nd, and adjourned to 23rd, to get a further certificate from the medical practitioner who
first saw the case. The certificate given was to the effect that the patient was " going on
satisfactorily," and that the certifier "saw no reason for the removal." The Order was
refused, and costs were awarded to the father. The child died three days later.
The case occurred whilst the Medical Officer of Health was away on vacation. From the
information obtained subsequently, it would appear that the Magistrate regarded the application as
made for the sake of the patient, and that he lost sight of the real need to remove the ease to
protect the other inhabitants of the house. The treatment and care of the patient are really
secondary factors in such a case. It is to be regretted that the case was not dealt with on the 21st,
or, better still, on the 20th. Verbal notice to the responsible party of the intention to apply for
an Order should suffice to secure an immediate hearing, otherwise much harm might accrue from
the delay.
There was no known case attributable to the child in question, but it is possible that early
removal to hospital might have saved her life. Parents are not, as. a rule, alive to the grave
danger of sudden death in cases of diphtheria, and allow their children to sit up and do things
which would not be allowed in hospital.
Disinfection of Rooms.—For the fumigation of sick-rooms cake sulphur is still relied on for
general use. The instructions given ensure that it is used in proportions in excess of 1 lb. to
1,000 cubic feet, the customary allowance. Formaldehyde gas and the spray machine (formalin)
are used occasionally. Stripping of walls and whitewashing of ceilings after infectious illness have
not been required, unless the room be dirty or the wall-paper much torn. Chloros powder
(chloride of lime) and carbolic soap have been distributed gratuitously to those who cannot afford