Report on return cases of scarlet fever and diphtheria notified for the three years 1902, 1903 and 1904 / by F.M. Turner.

  • Turner, Frederick Meadows.
Date:
1906
Catalogue details

Licence: In copyright

Credit: Report on return cases of scarlet fever and diphtheria notified for the three years 1902, 1903 and 1904 / by F.M. Turner. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    In the previous table it wiT be noticed that 1*5 per cent, of the cases transferred from the South-Eastern were, after discharge from the Northern Hospital, associated with the illness of “ return cases ”; from the Western Hospital 3-1 per cent.; and from the remaining hospitals, namely, the North-Eastern, North-Western, Fountain and South-Western from 2*3 to 2-7 per cent. The figures, as they stand, suggest that the South-Eastern Hospital transferred the fewest mucous cases, the Western the most, and the remaining four hospitals nearly the same amount, the Eastern Hospital being excluded from this comparison. Now, if these last four hospitals be contrasted, it will be seen that, although the type of case transferred was apparently the same,yet the number of “ infecting cases ” at these hospitals varied from 2*3 per cent, at the North-Eastern, to 4 per cent, at the North-Western. That the favourable results of the North-Eastern Hospital were not due to any special selection of transfers is also shown, on examining the table more in detail. Over 25 per cent, of the transfers from this hospital were sent to the Northern Hospital, after a period of detention of less than two weeks; 85’6 per cent., after less than four weeks, and the remaining 14*2 per cent., after four weeks and over. If there had been any selection, it could not have been on account of the severity or ehronicity of the mucous cases, for the patients transferred last were associated with fewer “ return cases,” than those sent in the first fortnight of their illness, the latter patients presumably suffering from very mild attacks. Nor do the collective results of all the hospitals indicate that the cases transferred were specially selected, for the patients transferred after a detention in the Acute Hospitals of less than four weeks, and those patients sent later, were associated with an almost equal proportion of “ return cases”—the “infecting cases” being 2*6 and 2 5 per cent, respectively, and similarly the percentages of “ infecting cases ” for those transferred under six weeks, and after six weeks, were 2-5 and 2*7 respectively. So that early and late transfers give almost equally good results. An examination, then, of the foregoing tables and charts does not show that the number of “infecting cases” at the Acute Hospitals is appreciably influenced, if influenced at all, by the transfer of patients to the Convalescent Hospitals, or that the patients transferred were specially selected. Wh en the evidence adduced in the previous section is taken into account, together with the fact that only 16 per cent, of the cases which suffered from a mucous discharge were transferred, it is obvious, that any result, other than that elicited by the enquiry, would have been unexpected. V. Acwte v. Convalescent Hospitals. A total of 10,818 scarlet fever patients was discharged from the Acute Hospitals; from the Convalescent Hospitals, the Northern and Gfore Farm, 4,683; the average period of detention of the patients being 68 days at the last named hospitals, or five days longer than at the Acute Hospitals. Patients were transferred to the Northern Hospital after an average detention in Acute Hospitals varying, from 18*7 at the North-Eastern Hospital, to 40 days at the Western Hospital. Their further detention is shown in the following table, which does not, however, include the figures for Gore Farm, as transfers to this hospital ceased shortly after this investigation commenced. Table 14. (August, 1901, to July, 1902.) Hospitals. Average period of detention. ' Acute Hospitals. Northern Hospital. North-Eastern 18*7 47o Fountain ... 37-3 26'0 North-Western 33*8 S 35*4 Western 40*0 36*6 South-Western 26-8 35*3 South-Eastern 30*7 39*3 j I W hen comparing the results of the Acute and Convalescent Hospitals, the type of case treated in these hospitals, and the age distribution of the discharges have to be considered. The B