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the diagnosis of a doubtful case of infection, and it is only by
observing many cases of each disease that a right decision can be
made with certainty.
Typhus Fever, Continued Fever, Cholera, Dysentery,
Relapsing Fever, Trench Fever, Poliomyelitis.—There were no
cases of these diseases notified.
Diphtheria.—There were 133 cases of this disease notified
during the year. The cases were scattered and not related to a
milk supply. Diphtheria is almost always a case-to-case infection,
and is spread by missed cases and carriers. When a case
of Diphtheria is notified arrangements are made to have swabs
taken for bacteriological examination from the noses and throats
of the contacts. Often this leads to the discovery of a "carrier,"
or of a missed case or mild case of the disease, which, if it was
not discovered, would continue to spread infection.
Scarlet Fever.—Only 126 cases of this disease were reported
throughout the year. There was no epidemic. With one exception
the cases were of a mild type.
At the present time we provide beds in our Isolation
Hospital for the treatment of cases of scarlet fever. To make
such provision is common in England and Wales. When
isolation hospitals were first established in England, nearly half
a century ago, Scarlet Fever was a severe and very fatal disease,
well meriting treatment in hospital; but to-day it is a trivial
complaint, much less fatal than measles, whooping cough or
summer diarrhœa. It may be, and is in some places, nursed
at home with safety. The home, nursing of scarlet fever would
liberate many hospital beds which could be used with greater
advantage for the treatment of other and more serious diseases.
It is well sometimes to revise our ideas with changing circumstances,
and not always to be satisfied with the pronouncements
of former days; and it is possible that we might with propriety
re-consider our views on the hospitalisation of scarlet fever, reserving
a few beds only for severe cases. The disadvantage of
the home-nursing of scarlet fever is that it would be unpopular
among the people, who greatly appreciate the services rendered'
to the sick at the Isolation Hospital.
Erysipelas was notified on 24 occasions.