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much of our late success at Mortlake in dealing with scarlet fever,
to practical action based on a belief that the two infections are
more frequently co-existent than is usually thought.
At the Isolation Hospital no new works have been
carried out during the year except those incidental to the
improvement of the "old block," which is now in a very satisfactory
condition. Minor repairs and cleansing operations have
also been effected, and the whole institution is now, I trust, in a
very fair condition of efficiency.
Owing to the availability of the new block, opened in 1909, the
management of the hospital has been of late relatively easy, as
the difficulties that used to arise when several diseases, and
patients of both sexes, had to be treated at once, are now overcome.
But there is one lesson, learnt during our former troubles,
that perhaps deserves statement.
It is that a system of bed isolation, such as I have described
in a paper published in the "Transactions of the Royal Society of
Medicine for 1910," may not only be of the greatest service in
overcoming difficulty created by an insufficiency of wards, but is
actually of the very greatest help in, at all times, preventing those
secondary infections that have been the bane of a hospital
superintendent's life; is of the very greatest importance to the
patients; and conduces, in small hospitals, to considerable economy
in the working of the nursing staff. This plan will, I believe,
entirely supersede the system, now extensively used, of constructing
separate cubicles, and may lead to not a little modification in the
construction of isolation hospitals generally. I can honestly say
that since we have adopted it at Mortlake we have had far greater
confidence than formerly in dealing with doubtful cases, and cases
of mixed infection. The only disease, except variola, which I am
not quite sure of controlling by this method is chicken-pox. The plan