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20
A medical practitioner having sent three successive
specimens from the same case to be examined in order to
ascertain when the patient was free from the bacilli of
diphtheria, I brought the matter before the Committee,
who authorised me to sanction such repeated examinations
when I considered it advisable.
Dr. W. J. Simpson having been appointed by the London
County Council to investigate " Returned Cases " of diphtheria
and scarlet fever alleged to prove sources of infection
on returning home, and having prepared an important
Report on the matter, the Royal College of Physicians
appointed a Committee to consider it, and their Report is
so important that I think it advisable to insert it in full:—
1. The Committee have carefully considered Dr. Simpson's
Report and the documents referring thereto, for the purpose
of expressing an opinion as to whether, and if so under
what conditions, the present period of detention of patients
in the Hospitals of the Metropolitan Asylums Board could
consistently with public safety be shortened.
2. The Committee are impressed with the small percentage
of those cases which, on investigation, were found to have
given rise to fresh infection, viz., 1*1 per cent, on the total
cases discharged from hospital of diphtheria and scarlet
fever taken together. They also note that of these no
fewer than 80 per cent, were suffering from some mucous
discharge, either during their stay in hospital, or shortly
subsequent to their return home.
3. The total number of return cases of diphtheria was
21, equal to a percentage of "5 on the cases of diphtheria
discharged. With reference to the length of detention in
diphtheria, the Committee are of opinion that this can only
be left to the discretion of the several medical superintendents.
The importance of the question of return cases
mainly turns on the length of detention of scarlet fever