Mr. W. H. Power's report to the local government board on diphtheria at the hospital for sick children, Great Ormond Street.

  • Power, W. H.
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Mr. W. H. Power's report to the local government board on diphtheria at the hospital for sick children, Great Ormond Street. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    cliambers provided in eacli turret at the end of the wing, ventilators from soil pipes, slop sink-pipes, and bath waste-pipes open by free ends; while into the eastern turret chamber of each wing there enters also a ventilating pipe from the trap of the main drain of the wing. These arrangements were noted as likely to be of importance if passage of air from one ward to another or of drain air into the wards should come in question. It needs to be added that beyond the various openings into exhaust chambers no other ventilating openings are provided to the hospital drains; the various closet and discharge pipes are carefully trapped, and no inlets for fresh air are provided. Incidentally the above details show that as regards drainage and ventilation, which are possible agencies for the propagation of infection, the two wings of the hospital had little or nothing in common ; in both respects they were distinct and separate one from the other. It has now to be noted that in certain other respects the two wings, with their contained wards, had much in common ; and this in the direction of conditions that might possibly have had concern with the outbreak. Water supply.—The water supply of the hospital is from the mains of the New River Company. For drinking purposes water is stored in two cisterns (one for each wing) situated in the roof of the administrative block. Though separated by a considerable interval, these cisterns are con- nected together by piping, and must therefore be regarded as constituting a single supply. Drinking water for use in the wards is obtained in each instance from a tap in the “ kitchen ” of the ward. The supply of water (cold) to baths, closets, and housemaids’ sinks is separate for each wing, and is obtained from cisterns situate in each of the four turrets already referred to. The source of supply of heated water is common to both wings. Food.—All food for use in the hospital is received in the central administrative block, and is thence distributed to the wards. Hence the wards must be regarded as obtaining food from a common source. Cooking operations are performed in the main kitchen of the hospital in the basement of the central block. Beyond warming of milk, beef tea, and the like, no cooking is conducted in the ward kitchens. In the Laundry arrangements there is community of circumstance for the several general wards. Administrative intercommunication between the wings occurs by means of the resident medical staff, and of the three “ Sisters,” each of whom has charge (on the same floor) of a ward in each wing. The Lady Superintendent and the Registrar of the hospital have naturally habitual access to both wings and all wards. The nurses are, while on duty, separate for each ward. At the date of the outbreak, the North (isolation) Block and the diphtheria ward had been for several weeks void of cases, while the five general wards of the hospital were practically full, and contained 102 patients. This number was within a few days of the outbreak reduced to 40; by discharge of such patients as could be sent to their homes and by removal of convalescents to Highgate. Admission of fresh cases to hospital at the same time ceased. On 14th March the Alice Ward was adopted for the treatment of diphtheria cases, which up to this time had been dealt with in the diphtheria ward ; scarlet fever was, as usual, treated in isolation in the North Block, and all other medical cases that had to be retained were collected in Victoria Ward. The retained surgical cases (which were more numerous than the medical ones) continued to occupy their own wards, Helena and Louise. For the purpose of this inquiry the facts of the outbreak have been grouped and regrouped in various ways with a hope of obtaining indications as to the cause of the diphtheria. For the purpose of recording some of the main features of the evidence got together, it will be enough, in supplement to the table already given, to formulate these facts as follows:—