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91
It will be remembered that in last year's report occasion
was taken to refer to evidence that existed of cross-type
infection in scarlet fever, in wards where the communal type
of isolation was in practice.
The research carried out by Drs. Allison and Brown had
furnished inconvertible proof that children nursed in common
were under risk of acquiring types of streptococci other than
those of their original infection, with resultant development
of so-called relapses and complications arising so late in their
illness as to be attributable to a new factor. This new factor
the investigators found was the irruption of other types of
hæmolytic streptococci than those found in their throats at
the time of their admission to hospital, and that as other
children in the common ward carried these freshly invading
types it was probable that the isolation in common of scarlet
fever cases required some modification in order to obviate the
hazard of late complications and relapses.
The obvious remedy, of course, would be cubicle nursing,
but cubicle nursing in any hospital built before the present
day is possible to only a few patients.
A scheme of bed isolation was therefore suggested as an
alternative, and authority for expenditure on certain necessary
equipment having been obtained, the system was put into
operation at the beginning of the present year (1938). Details
of the results of this method of isolation belong to future
annual reports.
Besides the actual nursing, there has been undertaken a
mass of bacteriological investigation, for the hemolytic
streptococci of each patient have been typed weekly, and
oftener, were any deviation from the malady's normal course
observed.
This latter type of work is for the expert bacteriologist
only, and Hendon has been fortunate in having the voluntary
service of Dr. Joyce Wright of University College, London,
and Dr. S. P. Elliott of the University of Cambridge in carrying
out this very important work, the delicate technique of
which is an earnest of the remarkable advance in modern
scientific methods.