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27
The disease generally was mild in type, and not all the notifications
were supported by positive indicia, some being made on
justifiable suspicion only.
A larger proportion than usual of the cases of diphtheria
occurred in the better class of houses.
1 am firmly persuaded of the advantages to the community
and the individual of the hospital treatment of infectious
disease, but the hospital must be sufficiently large, properly
equipped, and rigidly administered.
An inadequately equipped and slackly administered hospital is
wasteful and of doubtful utility.
It is often said by those in immediate attendance on cases of
diphtheria or scarlet fever nursed at home that the disease does not
spread, under such conditions, to the extent that public health
officers declare.
The truth is, no doubt, that when reasonable care is taken,
secondary cases are often apparently conspicuous by their absence
so far as the immediate attendants are concerned. But the disease
appears in the vicinity of houses where cases are kept at home far
more frequently than in vicinities from which cases are removed, and
apparently unconnected cases are often really linked to the primary
cases by a chain of carrier contacts.
Hospital isolation breaks this chain of carrier contact, whenever,
that is, there is a proper system of administration and ritual
observance at the hospital.
The long discussed new block at the Mortlake Hospital
is now nearing completion, and by April or May we should