View report page

85
These results show the percentage return-case rate after hospital
treatment (6.14 per cent.) to be more than 7 times greater
than after home treatment (1.03 per cent.). Of the return cases
following patients discharged from hospital, 20 occurred in the
first week, 30 in the second, 16 in the third, and 8 in the fourth
(i.e., 65 per cent, occurred within 14 days of discharge from hospital).
There is no evidence of any increase in return cases during periods
of pressure and overcrowding of hospital beds—in fact, the year
with the lowest hospital return-case rate, 1934, was one in which
the complication incidence rate was exceptionally high.
Disinfection.
The elaborate ritual of terminal disinfection owes its origin
to the assumption that infection is conveyed by inanimate objects
handled by the patient, by his clothing, and by the very furniture
and walls of the rooms in which he lived. Bacteriologists have
demonstrated the existence of hemolytic streptococci in all these
situations; but these micro-organisms are parasites requiring
warmth and moisture for their existence, and outside the body
they perish quickly. As long as the infectious person is in the
house or hospital, he can infect others; but when he goes the risk
of infection generally goes with him and, except in a few special
cases, it may be said that soon after the patient has been removed
any germs he may have left behind are so moribund that the need
for terminal disinfection has passed.
It is surprising how little is claimed for disinfection, even by
its staunch advocates. There are many who take up the attitude
that, even although it does no good, it can do no harm; but can it
not do harm? Dr. Forbes (Medical Officer of Health, Brighton)
has drawn attention to serious harm which may be done by the
spraying of living rooms with liquid disinfectant; to the overcrowding
of the family caused by the closing of rooms which have been
sprayed; and to the sense of false security conveyed to the public,
who have been led to regard municipal "spraying and baking"
as the last word in disease prevention.
Prior to January, 1930, the Leyton Sanitary Authority carried
out the traditional programme of municipal terminal disinfection
of bedding, clothing, etc., from infected households. Since that
time these measures have been discontinued in the commoner
notfiable diseases.