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when the patient "catches cold," is shed on to the clothes, utensils and handkerchiefs.
The organism, morever, finds in the discharge the food and moisture requisite
for growth and propagation. Klein, Gordon, and Moser claim to have found the
Streptococcus Scarlatinae present in specimens of these discharges examined by them.
6. Bronchitis; Coryza; Faucitis (sore throat). Cervical Adenits (enlarged glands
in neck).
Any of these may be present at or soon after the patient's discharge from
hospital.
7. Too long a period of detention in hospital.
Some authorities maintain, apparently with very good reason, that rhinorrhea
and otorrhea are propagable in a ward, and may be communicated not only to
patients in immediate contiguity with the one affected, but to others in remote
parts of the ward.
Thus it frequently happens that a patient in all other respects convalescent
contracts a nasal, aural or buccal discharge shortly before he is ready for home, by
sitting down at meals, fondling, playing with or otherwise being brought into contact
with a patient already so suffering.
This possibility and distinction is recognized by the Metropolitan Asylums
Board, but is, so far as I know, only acted on in the conveyance of convalescent
patients to the Northern Convalescent Hospital at Winchmore Hill. The clean and
unclean patients (having rhinorrhea, otorrhea or stomatorrhea) are conveyed in
separate vehicles.
These exudates may later prove the infecting agents in causing return cases.
The common-sense inference, however, is the necessity not so much for shortening
detention in hospital as for immediately isolating any case of Scarlet Fever
associated with a serous or purulent discharge from nose, mouth or ear, apart from
other patients.
The measures, preventive and ameliorating, adopted and suggested include:—
1. A warm bath the night before discharge from hospital, sleeping that
night in an isolation room, and conveyance home on the subsequent day in a cab
or ambulance, thus obviating as far as possible the danger of "catching cold" on the
way.
C