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30
The institutional treatment of pulmonary tuberculosis is very unsatisfactory
for the reason that it is necessary in the majority of cases for the patient to
return subsequently to bad social conditions at, home, and with our present
knowledge the only really satisfactory w ay of dealing with the patients is to
place them permanently in the surroundings best suited to the nature of their
illness. This can only be done by the provision of a sufficient number of
industrial or farm colonies, sanatorium schools, hospitals for advanced cases, &c.
SCARLET FEVER.
246 St. Pancras (civil) patients were notified during 1917 as suffering
from scarlet fever. Of these, 22 were afterwards found not to be (suffering
from scarlet lever by Medical Superintendents of the Metropolitan Asylums
Board Hospitals.
This gives the net number of cases of scarlet fever notified during the year
as 224, equal to an incidence rate of 1.08 per 1,000 population, and 1.20 per
1,000 civil popu'ation.
The number of cases of this disease notified during the year was very much
less than any other year since ! 889, when the disease was made notifiable.
The number of deaths from scarlet fever cerified during the year was 4,
equal to a death-rate of 0.02 per 1,000 population, and a case mortality of 1.8
per cent, of cases notified.
Other statistical facts in regard to the disease will be found on pages 13 14.
Of the notified cases of scarlet fever, 238 (or 96.7 per cent.) were removed
to hospital, as follows:—
To Metropolitan Asylums Board Hospitals 236
To other hospitals 2
288
Return Cases.—Only 3 return cases (in 3 houses) of scarlet fever were recorded
in 1917. In each instance the return case was in the same family as the
infecting (?) case. The intervals between the return of the first case and the
onset of the second were 2, 5, and 23 days respectively. Two of the infecting
(?) cases showed no signs of infectiousness and one had a nasal discharge.
There were no cases of scarlet fever recorded as following upon the return of
cases of diphtheria.
On page 32 will be found a reference to after-care work amongst scarlet
fever and diphtheria patients.
DIPHTHERIA.
451 St. Pancras (civil) patients were notified during 1917 as suffering
from diphtheria or membranous croup. Of these, 70 were afterwards found
not to be suffering from diphtheria, 69 by Medical Superintendents of the