View report page

1907]
158
long lived. Indeed, I think that I have proved this is not so in the three preceding
sections of this report. When we consider for a moment what would happen if
these cases were not removed, but allowed to remain at home in tenemented
dwellings during the whole time that the patient remains in an infected state, we
are driven to the conclusion that constant supervision of the patients would be necessary to
see that they did not expose themselves or were not exposed by their parents or guardians during
the long period of their convalescence, and that this would j ecessiiate the employment of a large
staff of visitors. Apart from which consideration there are the disabilities that would
necessarily follow school children and parents, which are fully set out under the ioth
section of this report. It is, therefore, necessary, when considering the cost of the
hospitals, also to recollect that if the use of the hospitals be largely curtailed, there
will be a large expenditure in the direction indicated, as well as a loss of money
through the absence of children from school, and also a large decrease in the
earnings of the parents or guardians of the children living in the infected houses.
16. The cost of isolating these cases has naturally arisen, and therefore we
find that whereas in 1890 it was £112,420, in 1906 it was £351,408, or more than
threefold (1: 3.12) while in the same period the Scarlet Fever admissions had
increased in practically the same ratio (1: 2.89).
We have now these facts before us respecting Scarlet Fever:—
(a) That the disease is chiefly one of young life.
(b) That it is usually most prevalent about October.
(c) That Bacteriologists are not agreed as to the bacteria which cause it.
(d) That the germ of the disease enters the system with the inspired air, lodging
in the digestive tract.
(e) That the infection is spread by the patient, by body clothing and by articles
that have been in contact with him; that he is most infectious when his
temperature is high; and that he is liable to convey infection for five or
six weeks. Also that infection may be conveyed by milk.
(f) That it is stated that apparently towns which have not largely protected
themselves by means of hospitals have suffered little more than those
which have.
(g) That the number of cases has decreased in London by 30,717 in the
quennial period 1901.5 as compared with the quinquennium 1891.95.
(h) That the proportion of the population attacked annually in the same periods
has fallen from 5.23 to 3.55 per 1,000 of the population.
(i) That in the same periods the deaths have decreased by 2,740 or 46.8 per cent.
(j) That in the same periods its fatality (the ratio of deaths to cases) has fallen
36.9 per cent.
(k) That the annual expenditure on the hospitals has risen in proportion to the
number of cases admitted, viz., from £112,420 to £351,408, while the
cases increased from 6,537 to 17,983.
(/) That if cases are not to be removed to hospital, a heavy expenditure must
be incurred in watching them, as well as their parents and guardians, to
prevent them spreading the infection, while schooling, and work and
businesses will be interfered with.
These are the chief facts respecting the disease so far as they concern us.