View report page

77
It is possible that there was a selection of severe cases for admission to hospital which
might account to some extent for this contrast, but since instructions were given to select cases
on account of home conditions rather than the gravity of the illness, it may be doubted if
selection of severe cases was wholly responsible.
Table II shows the mortality rate during the 1927-8 epidemic compared with those of
previous epidemics in this Borough, before special efforts were made to admit cases to hospital.
Here again, the comparison does not appear favourable to hospital treatment. It would be
interesting to know if these results find any parallel in other Metropolitan boroughs: if so, it
would seem to suggest that the disturbance to young children suffering from this disease or its
complications, caused by removal to hospital, might be in itself a factor of importance in
producing the relatively high mortality rates which were recorded there.
With reference to the difference between the mortality rates at the M.A.B. hospitals
and Highgate Hospital a word of explanation is necessary. The Medical Superintendent of
High gate Hospital thinks that the most important cause was the overcrowding of the wards. He
states that little pressure had been expected in view of the special preparations for the epidemic
made in the M.A.B. hospitals, also, that two of his wards were out of use owing to building
operations. In February, when the M.A.B. hospitals were full and declined to receive any
more patients, he was obliged to admit cases, whether he had proper accommodation or not.
He mentions also that about 50 cases (not counted as being nursed at Highgate) were
sent on, almost immediately after admission, to the M.A.B., and were those best able to travel,
the more serious cases being retained.
Further investigation into this question is necessary, but at present it would appear that
home isolation, with the provision of the services of a nurse, is the most suitable treatment.
As a preventive measure, especially in very young or delicate children, the method of
protection by the injection of convalescent serum may prove to be of value. This method
has been used for some time both in America and on the Continent, and the results are reported
to be extremely satisfactory. In this country little use has so far been made of this mode of
protection.