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137
It is to be regretted, that occasionally the hospitals of the
Asylums Board are overtaxed and cases have to be treated at
home. Not only is there risk of spread from the particular
cases for which admittance can not be obtained, but it increases
our difficulties in endeavouring to obtain removal of all cases
from tenement houses at times when there is plenty of room in
the hospitals.
Those which have been treated at home are quoted to us
when we are pressing for removal, and with selfish disregard of
the risk to others, cases are frequently retained at home and
nursed in totally unsuitable rooms. The action of the general
hospitals probably assists to some extent in the spread of
diphtheria. In the course of the disease, blocking up of the
air passages (often coming on suddenly), may necessitate
the operation of tracheotomy. In such cases it would bo
difficult to prevent the relatives rushing to the nearest hospital
without much thought being given to the exposure of au infected
person, and the hospital authorities are perhaps justified in
receiving and treating such cases without demur or discussion.
The same excuse, however, is not available for the very common
practice of seeing diphtheria cases among out-patients—often
taking a swab from the throat for bacteriological examination,
and giving instructions for the child to be brought again to the
hospital—without any special precaution against the risk of
spreading infection being insisted upon.
In connection with the subject of infectious disease, I may
mention that a register of each school situated in the district
is kept, in which from day to day are entered the cases of
notifiable infectious disease occurring in scholars; anything in
the nature ot an epidemic connected with any particular school
is therefore quickly detected and the nccessary steps taken. In
the same way a register is kept of all milk purveyors so that a
milk epidemic would in the same way be detected immediately.
It used to be the custom of the Sanitary Department to
forward to the Public Library a list of all cases of infectious
disease occurring in the Parish; as these long lists had to be