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obtained are not so good and the relatives may not be able to stand the
expense. The word, '"expense" is used in a wide sense. The Committee
pays the Hospital charges. There is in addition the expenditure in time
and energy on the part of the patient and a relative, usually the mother.
After the operation has been done and the patient is discharged from
hospital a long and regular attendance at the Out-patient department
follows. Each attendance often means a long wait in the hall with
consequent disorganisation of the work at home, and discomfort. The
visit to the hospital is necessary, but the long wait is unnecessary.
" For the sake of the sick and their guardians, and in tha interests
of the hospital itself and its staff, it would appear advantageous by
good organisation and by a system of appointments, to avoid irksome
delay.
" The treatment of mastoid cases after operation is long and troublesome.
As long as the conditions referred to exist, one hesitates before
sending such cases to hospital. If attendance fails or becomes irregular,
healing is impaired. An unhealed mastoid is a greater burden than a
mastoid which has not been operated upon."
INFECTIOUS DISEASES.
Review of the action taken to detect and prevent the spread of infectious
diseases:—
School nurses make regular visits to schools principally in connection
with cleanliness surveys. When infectious disease makes its appearance
in schools, the nurses are alert to find out any children who present
appearances suggestive of the early stages of infection and have them
excluded. The teachers are equally vigilant to prevent the attendance
at school of suspects.
Children who have been absent from school on account of notifiable
infectious diseases are, with their contacts, medically examined, including
in the case of diphtheria, bacteriological examination, before re-admission
is granted.
Generally, the recommendations of the ' 'Memorandum on Closure of
and Exclusion from School" of the Ministry of Health and Board of
Education are complied with.