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74
above these deaths there are 15 deaths to be recorded amongst infants born in hospital. Later on in
this Report I will draw attention to the fact that, in my opinion, it was possible to deal with the
number of cases admitted only by putting undue strain upon the members of your hospital medical
and nursing staff; and, in that connection, it may be judged what is the nature of the strain at the
time of writing, when the monthly admissions are more than double what they were a year ago. To
my mind the necessity for more staff and for more staff accommodation is, if possible, more urgent
than for ward accommodation, and it is a matter which I submit, with all due respect, the Council
should take into consideration without delay.
Infectious Cases.
Passing to the infectious cases, there is nothing of particular note, except that the number
of diphtheria cases admitted was higher than any year yet recorded, and that the number of enteric
fever cases was only 2.
Of the 723 infectious cases, 238 suffered from Scarlet Fever. In 1918 there were 111.
„ „ 431 „ Diphtheria „ „ 223.
„ „ 2 „ Enteric Fever „ „ 7.
„ „ 52 „ other diseases „ „ 427.
In connection with "Other Diseases" it should be noted-that this year the 52 include infectious
diseases only, whereas in 1918 and previous years this class included not only these infectious cases
other than Scarlet Fever, Diphtheria and Enteric Fever, but a number of wrongly diagnosed cases,
most of which were of a non-infectious nature. These latter I have now included amongst the diseases
set out in the tables dealing with children under 5 years of age and of school age.
Scarlet Fever.
By reference to Table No. 70 it will be seen that 261 cases of Scarlet Fever passed through the
hospital, and of that number only 4 died. There is no doubt that this disease is becoming milder.
It is an uncommon thing now to see the more severe types of attack which twenty years or more ago
were comparatively common. Scarlet Fever, however, though a mild affection, is one which, if at all
neglected in the earlier weeks of the illness, may prove dangerous should certain complications arise.
Diphtheria.
As regards this disease, a very fatal one in children if not treated early, the number admitted
was unusually high. The mortality, however, in spite of the fact that the general type, in the late
part of the year especially, was severe, remains at the satisfactorily low level of 4.9%. In 1918 it
was 9-1%. Five cases were admitted in a hopeless condition due to toxaemia.
Anti-toxin was given in all cases requiring it, and these numbered 334 out of the 431 cases
admitted. It is needless to say that no death took place amongst those mild cases from which antitoxin
was withheld.
In a later table (No. 74) I give the day of disease on which the diphtheria patients were admitted.
This day of disease is a matter of vital importance in connection with diphtheria, for it is recognised
that if anti-toxin, which has brought about such a wonderful reduction in the mortality, is to have
effect the patient must come under treatment at the earliest possible date. A patient with wellmarked
attack has very little chance of recovery if he comes into hospital later than the fourth day,
for obviously the disease has had four days' start during which the poison may have done irreparable
damage to the patient. Everything should be done, therefore, to expedite the admission of the
patient to hospital. Unfortunately, during the war, owing to the shortage of medical staff, the
bacteriological laboratory at the hospital was closed, and arrangements were made whereby throat
specimens, etc., which might be sent in by medical practitioners should be sent to London for examination
and report. This arrangement means a delay of 48 hours before the result is known. I believe
that this delay adversely affected the chances of recovery of certain patients admitted during the year.
That being so, there is every justification, in my opinion, for the provision of the necessary medical
staff and the reopening of the laboratory.
Enteric Fever.
Of Enteric Fever, 1 patient was admitted in the acute stages of the attack, and 1 in the convalescent
stages. The former case (from a neighbouring district) ended fatally.
" Other Infectious Diseases."
Coming now to " Other Infectious Diseases," the total admitted was 52. I have included in
this list the following cases :—
Measles 29, of which 2 died.
Whooping Cough 2 „ 0 „
Rubella 2 „ 0 „
Mumps 1 „ 0 „
Influenza 16 „ 4 „
Erysipelas 1 „ 0 „
Poliomyelitis Anterior Acuta 1 „ 0 „