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approximate £400. Moreover, medical opinion with
regard to the causes and duration of infection is
undergoing, and is likely still more to undergo, considerable
changes. It has been known for some
time that what are called "return cases," i.e., cases
that after their discharge from hospital, to all intents
cured, but which have yet infected others, owe their
infection to ear, throat, nasal and post-nasal discharges
in most, if not all instances, and not to desquamation.
This latter can far more positively be
controlled, and the belief is gaining ground that if
this is so, hospital detention will come to be considerably
shortened. Under such conditions this
would, in the case of an epidemic, permit of a larger
number of cases passing through the hospital with
the same accommodation as exists at present, and
greatly diminish the cost.
Taking these two points into consideration,
viz.:—The more successful control of an outbreak
that may result from observation wards, where none
have hitherto been provided, and the change that is
taking place in medical opinion, having its basis on
statistics gathered from the use of Isolation
Hospitals in dealing with Scarlet Fever, and the
experience accruing from advances in treatment, I
would advise that there is no immediate need for
large additional expenditure.
Diphtheria.—There were 3 cases during the
year, but only 1 was removed to the Hospital. No
deaths. One case was contracted outside the
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