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to itself. Again cases are not infrequently sent in as cases say of Scarlet Fever or Diphtheria which
do not prove to be these diseases but perhaps German Measles or Measles or some other Infectious
Disease. Meanwhile, such cases have been admitted to the Scarlet Fever or Diphtheria Ward and
very likely infected other cases in these wards. Isolation beds or cubicles are required not only for
the case wrongly sent in to Hospital, but also for the cases of mixed infection arising as a result of
this occurrence. Then again a case of Diphtheria may be sent into Hospital while it is incubating
Chicken Pox or a case of Scarlet Fever may be sent in which is incubating Whooping Cough. The
diseases which such cases are incubating develop during the stay of the case in the Diphtheria or
Scarlet Fever Ward as the case may be, and suitable and adequate provision for the separation or
isolation of such cases is immediately required. Diphtheria again is not infrequently a sequel of
Scarlet Fever and no provision exists in connection with the Wards or otherwise for the separation
of these cases as they arise.
The Wards generallv at the Hospital are large long Wards and in none of these long Wards is
there any Side Ward or Separation Ward. The result is that there is no separation accommodation
for a very ill case in any Ward and the general noise in the Ward from the more or less convalescent
patients or children is not good for the treatment of very ill cases. Then again in respect of the
Diphtheria Ward Tracheotomy has to be performed in this Ward with screens around the operating
table as no side room of any kind exists which might be used for the operation.
Mothers and Diseases of Women.—In connection with these cases there is often one of difficult
labour where the patient should be put into a recovery room for some time before joining the patients
in the Ward, but an arrangement of this kind is not available at the Hospital. Similarly other serious
cases in connection with women require separation.
Diseases of Children.— In connection with all children's wards, separation accommodation is
exceedingly necessary because children are frequently admitted to Hospital during the incubation
period of Measles, Whooping Cough, Chicken Pox, Scarlet Fever and other exanthemata common
amongst children. These diseases frequently develop during their stay in the Ward and immediate
arrangements for separation should be available. Then again cases of school children suffering
from Scabies, Impetigo and other infectious skin conditions in chronic form are admitted for treatment.
Such cases should not mix with others and really require separation cubicles.
General.—Owing to the pressure on the available accommodation at the Hospital it has to be
observed that the general arrangements as to patients are from time to time unsatisfactory. For
example, in connection with the present epidemic of Scarlet Fever, it has been necessary to put
bigger boys and girls in the same Ward and this is an arrangement which may very properly be
objected to. Similarly in some of the Wards, it is necessary to have adults with children or babies
and the playing of the children or the crying of the babies cannot be said to aid the recovery of the
adult.
It is very necessary during seasons of particular stress in Hospital that sufficient provision
should be made for an adequate staff. The staff at the Municipal Hospital works long hours and
unless adequate provision is made for their rest and recreation especially during epidemic times they
may themselves go down with illness which may be serious not only to themselves but to patients.
GEORGE F. BUCHAN,
Medical Officer of Health.