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13
During the year, I received notification of the following diseases:—
4 cases of small-pox, 1,143 of scarlatina, 675 of diphtheria, 290 of
enteric fever, 11 of continued fever, 13 of puerperal fever, and 6 of
cholera. The latter were all, apparently, of the English type. The
chief of these were fairly distributed throughout the various districts
of the Borough, no marked epidemic being noticeable in any one
district. It will be seen that the fresh cases of infectious disease
averaged weekly, 22 of scarlatina, 13 of diphtheria, and 5 of enteric
fever. With regard to the latter, I hope that, in the near future, we
may gain considerable improvement by prompt removal to hospital.
We have lately had an instance in which a series of cases, occurring
one after the other, have kept the disease alight in one house for over
six months, and. apart from the trouble and loss entailed thereby- upon
the occupying tenants, have prevented the execution of necessary
repairs. Theoretically, it should be possible to easily isolate this
disease to the sick-room ; practically, in working-class houses it is impossible;
and although the authority supply disinfectants, and the local
district nurses do yeoman service in the course of their daily ministrations,
the actual results are disappointing, partly because the relatives
of the patient have not the time to devote their sole energies to the
care of a sick person, but chiefly because the rationale of aseptic
nursing of infectious disease, while simple and easily understood when
read in pamphlet or paper of directions, requires for its full fruition
the constant daily practice which gradually engrains the innumerable
minutiae of detail necessary for the efficient nursing of such a disease
as enteric fever into the very being of the person in charge, until, at
last, the carrying out of these requisites becomes almost automatic.
Such automatonism is unattainable in the dwellings of the poor,
where the problem of the recovery of the sick is too frequently complicated
by that of the survival of the non-sick.
The four cases of small-pox notified need only a short reference.
Three of the cases were in young children of one family notified at
the same time, and treated at home without difficulty. The fourth
case, occurring at the end of the year, was sent to the Metropolitan