Report of the medical superintendent of Yaws Hospitals.

  • Nicholls, H. A. Alford (Henry Alfred Alford) 1851-1926.
Date:
1878-9]
Catalogue details

Licence: Public Domain Mark

Credit: Report of the medical superintendent of Yaws Hospitals. 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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    isolation, the organization codd not be nearly so closely attended to, and a long interral elapsed between the yisiti of tie medical efficers. The act of absconding from the hospitals has been fortaaately all but stopped of late. Formerly it was a frequent thing for patients te leave the hospitals uncured, as may be seen from the st atistics of the Prince Raperts Hospital; and I believe great numliers of the patients admitted t© Morne Bruce before April 1877 ran away UDcured. Two yaws constpbles wero appointed during th© year 1878, one to the northern district of the Island, and the oLher to reside at the Central Hospital, which is the headquarters of the southern district. The prin- cipal duties of these officers are to collect yaws patients, to keep a sur- veillance on those persons discharged cured so as to detect any fresk attack of the disease, to obtain infornaatioa concerning yaws ani yaws patients, and to arrest any person who may run away from the hos- pitals. Besides the patients mentioned as having absconded from the Central Hospital several others effected their es<5ape ; they Were how- ever speedily brought back by the constableg, assisted by the Polios Authorities, although in some instances the runaways had reached a remote part of the Island. During the year I have received much assistance from the polios in gettin^^ yaws patients inte the hospitals, Inspector James haviag instructed the men under his command to lend their aid when called upon to do so. The number of deaths next claims attention. In the Central Hospital there were 24 deaths to 493 admissions aad 3 births—about cen- tum ; and at Prince Ruperts there were 16 deaths to 33S admissions and 3 births—about 4*2 per centum Thus it would appear at first sighs that the death-rate of the lormer hospital was slightly in excess of the latter ; but it must be remembered that all the old standing cases to the number of 110 were removed from Morae Bruce and Prince iiu- pertsto the Central Hespital, so that the mortality at the last named establishment was really 24 deaths out of 606 iamateSj or only 3*9 per centum. Altogether 61 patients have been re-admitted, but of this number only 17 were treated in the first instance at the Central Hospital ; of the remaining 44 cases, 19 were re-admisaions from Morne Brnce and 25 from Prince Ruperts. As I am not in possession of correct re- turns from the Morne Bruce Hospital, I cannot form an estimate of the per-ceotage of re-admissions, but at Prince Ruperts it was 9 4, and at the Central Hospital it was only 3 6. Of these 61 cases, 3 were admitted a third time, each of the three cases having been first treated in a different hospitaL In some instances it may be that the patients have been discharged imperfectly cured. The utmost vigilance is exercised by every mem- ber of the staff to prevent an inmate from leaving the hospital unless the disease is thoroughly eradicated from the system, but in spitQ of the greiteit care some few cases of imperfect cures rnay escape observation. 1 am confident however that most of the re.admissions to the Central Hespital are genuine examples of fresh attacks of the disease, as the history of the two interesting cases given in the appendix will tend to show. [See Appendix A.] In these two cases the second attacks of the disease oecurred too long after the first to be ascribed to a relapse. Neither can it be said that the patients were sent away imperfectly cured, for when the boy was discharged I made a very careful examination of him, and no sign of the disease was visible ; and the woman was under the observation of the medical staff from tho date of her discharge on Oot. 18th, 1877, until February 9th, 1878, and during this time no symptom of the dis- ease manifested itself. In each of these casee therefore it may safely be inferred that the second itjvasion was distinct from the first and that