Dr. S.W. Wheaton's report to the Local Government Board on diphtheria in the Enfield Urban District and on sanitary administration by the Urban District Council.

  • Wheaton, S. W.
Date:
1909
Catalogue details

Licence: In copyright

Credit: Dr. S.W. Wheaton's report to the Local Government Board on diphtheria in the Enfield Urban District and on sanitary administration by the Urban District Council. Source: Wellcome Collection.

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    observation purposes. Owing to the want of accommodation, 29 cases of diphtheria from Enfield district could not be received and eight from Edmonton. These were by arrangement sent to the hospitals of the Walthamstow or Cheshunt Urban District Councils. The accommodation for the nursing staff, which is pro- vided in an administration block, in a temporary iron building, and in the porters lodge, is insufficient. Although at the time of my visit, the hospital contained a smaller number of patients than at any time since October 19th, 1908, two nurses had to sleep in the town of Enfield. There is a resident medical officer and a medical superintendent, the latter lives in Enfield. On admission the patient is examined by the resident medical officer. All the buildings are connected by telephone, so that he can be summoned at once. The clothing which the patient is wearing on admission is removed, disinfected at the hospital, and retmmed on his discharge. The blankets in which the patient is wrapped, which may belong to the parents or householders or to the district council, are returned in the ambulance and disinfected by the district council. Antitoxin is administered to diphtheria patients by the resident medical officer on admission, the dose given being proportionate to the severity of the case. Parents not infrequently are allowed to accompany children to the hospital in the ambulance. The resident medical officer makes smear examinations of the secretions of the throat in diphtheria cases soon after admission. Patients who have had diphtheria are not discharged from hospital until two successive cultures made from the throat have shown the absence of diphthei’ia bacilli. The medical superintendent examines all patients on the day of discharge from hospital. The parent or friend removing the patient is given the opportunity of also examining the patient, and of making any observations in a book provided for this purpose. A record is kept of the presence of any sequelae of the illness, such as discharge from the nose or ear. There is no arrangement for sending dis- chai’ged patients from Enfield to their homes, which are often many miles from the hospital. This has not even been done in the case of patients sent to Cheshunt or Walthamstow hospitals. Trams are not available and the railway is of little use for patients returning home. A notice is sent from the hospital to parents or friends two days previous to the discharge of the patient, telling them the day and hour at which he is to be removed and also cautioning them not to bring to the hospital children or persons who have not had scarlet fever. A form is given on discharge with printed instruc- tions for avoiding risks of infection from the patient, also advising isolation of the patient if discharge appears from the nose or ears, and the sending for a medical man if this occurs. In the case of diphtheria a printed slip is added advising the calling in of medical advice if symptoms of paralysis, indicated by alteration of voice, defect of sight, difficidty in swallowing, or loss of power in the limbs, should occur subsequent to discharge from hospital. Diphtheria and enteric fever patients on recovery are discharged from their wards ; the discharging block is used tor discharge of scarlet fever cases only. The Enfield Urban District is included in the Middlesex Districts Joint Small-pox Hospital District.