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42
Disinfection was carried out after each, including the clothing, &c., of
those in attendance. In four instances there were insanitary conditions
existing. Two of the cases might properly be excluded from the list,
as the illness was not the result of the condition ; in one case it arose
from an accident fourteen days after confinement.
In London as a whole there was a slight increase in the number of
cases.
Mistaken Diagnosis of Cases of Infectious Diseases.
This question has arisen from a statement reported to have been
made on the presentation of the Annual Report of the Metropolitan
Asylums Board, to the effect that nearly 2,000 cases of mistaken
diagnosis had been admitted during the year, that the consequent
expenditure, which never ought to have been incurred, was £12,000 for
the year, and that the cases ought never have to come into the
hospitals.
The report of the Board shows that 10.7 per cent, of the total
admissions were found not to be suffering from the diseases mentioned
in the certificates upon which they were removed to hospital, the
percentages being. 6.7 on the total scarlet fever cases, 16T on the
diphtheria, and 25.9 on the typhoid fever cases.
Examination of the reports of the previous years show that 10 per
cent, has been the usual amount of error. It is a matter for regret that
such errors should occur, but it should be understood that in the
majority of instances every care has been taken in making the diagnosis
by the general practitioner. Take, for example, diphtheria. It is of
the utmost consequence to the patient that appropriate treatment be
given at the earliest possible moment; yet diphtheria if not always
easy to diagnose. There are several conditions of the throat of an
infectious nature which look like diphtheria, and it is only by
exhaustive bacteriological examination that the difference can be
detected. Under such circumstances it is surely better that the
sufferers should be removed at once to hospital rather than that
they should be detained in their own homes, where, in the majority of
cases, they would be a source of danger to others.
A medical man may have strong suspicions that the complaint for
which he is called in is of an infectious character, but it may be some
days before the eruption appears. In the houses of the well-to-do he
may take preventive measures and isolate the patients until he can
definitely decide, but in the houses of the poor this is impossible, and
the only alternative to keeping the patient at home is to have him
removed as early as possible.