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patient who has been detained for a much longer period. Nevertheless,
the older members of the general public still view with
suspicion any detention period less than six weeks; and quite
recently it was reported that in a village in the north of England
"widespread distress and something like a state of panic" existed
among parents who refused to send their children to school for fear
of contact with other children alleged to have been prematurely
and improperly released from the local isolation hospital.
Complications and Overcrowding of Wards.
With regard to the incidence of complications, it is reasonable
to suppose that, with all the expert care of patients in hospital,
complications are more quickly detected and more adequately
treated than they would be at home; but I know no facts or figures
to support that supposition. As the result of a questionnaire on
this subject addressed by the Ministry of Health to Medical Officers
of Health and Medical Superintendents of Infectious Disease
Hospitals in 1923, it was found that only a minority (28 per cent.)
considered that hospital treatment had any effect in reducing the
incidence of complications.
On the other hand there have always been observers who have
maintained that the mixing of different types of infection in hospital
wards tends toward the development of complications and cross
infections by patients who would have had uncomplicated attacks
if they had remained at home; and recent investigations appear
to provide bacteriological evidence in support of that contention.
For example, as the result of weekly bacteriological examination
of 200 consecutive cases it was found by Allison and Gunn that,
whereas 54 per cent. showed no change in type, as many as 46 per
cent. showed a second or third type of hsemolytic streptococcus
during their stay in hospital. Of those who did not show change
in type, 16 per cent. were carriers on discharge after 6.5 weeks in
hospital; whereas of those who showed change in type, 62.6 per
cent. were carriers after 7 weeks detention in hospital. It is very
significant that patients nursed in cubicles showed no change in
type.
It has been shown conclusively by Griffiths, by Gunn and by
Allison and Brown that infection by one strain of hsemolytic streptococcus
does not protect against subsequent infection by another