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weeks, two having been detained over 16 weeks, a fact which
indicates that the increase of duration of stay in hospital cannot
be looked to as a means of avoiding return cases.
25. Dr. Simpson's Report on return cases, dated 5th June,
1899, has at last been published by the Asylums Board. Dr.
Simpson finds that 1.6 per cent. of cases discharged from Hospital
are the means of infecting other members of the family on
their return home, and that the majority of them are infective
through discharge from mucous membranes such as the mouth,
throat, nose, and ear. He makes the following recommendations
for obviating the occurrence of such cases:—
(1). That warm baths should not be given immediately before
the convalescent is sent out of Hospital, especially in
winter.
(2). That the cases are not due to premature discharge, but
that duration of stay in Hospital should be diminished.
(3). That local and antiseptic treatment should be applied for
discharges from mucous membranes, and that patients
should be moved to less infective wards before discharge.
(4). That the Medical Officer of Health should be notified as
to discharge of the patient from Hospital, or printed instructions
should be given to the parent or guardian as
to suitable precautions.
(5). That Sanitary Authorities should pay attention to steam
disinfection of clothes, toys, such as dolls, &c., as well as
to bedding.
The report having been referred to the College of Physicians
they recommend further investigation, and meanwhile it appears
no action will be taken.
The recommendations (2), (3) and (4) fully bear out the
opinion I have frequently expressed, and as regards (3) and (4)
I fail to see why they should not be at once carried out as far
as possible.