Annual report for the year 1906 : (9th year of issue) / Metropolitan Asylums Board.
- Metropolitan Asylums Board (London, England)
- Date:
- 1907
Licence: In copyright
Credit: Annual report for the year 1906 : (9th year of issue) / Metropolitan Asylums Board. Source: Wellcome Collection.
405/418 page 341
![respectively. If my view be correct, there should be some additional influence at work in winter which affects the town and country differently. I think we have it in the irritating, catarrh-producing London fog. Patients in town hospitals to some extent are used to it, but patients in the country know it not. The latter have therefore been shielded from one additional and important weather condition to which they have to become re-acclimatised when they return home, and in the process they often suffer. The experiment seems well worth trying of having the convalescent hospital, or as I prefer to call it, the preparation-for-home hospital, in the district where the patient lives, so that he may breathe the same air as that of his home. At the same time he will be as much removed from the concentrated infection of the acute wards as if he had been sent to the country. That such removal is of great value I fully believe, for my objections do not apply to convalescent hospitals in general, onjy to those situated in the country. In fact, one of the greatest puzzles has always been that although the country hospitals possess this enormous advantage, they do not show better results. (iii.) Discharge of Patients from Hospital.—The mode of procedure, now happily discredited, but not yet generally discontinued, has usually been as follows : The patient, after a stay of 6 weeks or more in luxuriously warmed wards, and carefully protected from the inclemencies of the weather, is one day led off to the discharge rooms. He has a hot bath and is thoroughly washed all over and carefully dried before a fire. He is then dressed in his own clothes, sometimes thin and insufficient, and delivered over to his friends. They take him home, perhaps in rain, or wind or fog; perhaps in a draughty ’bus or train. What reason for wonder is there that sometimes he “ catches cold,” that rhinorrhoea begins, and return cases follow. I suppose, if we were to deliberately set to work to produce nasal catarrh, we should choose some such method as that just described ; yet that is the procedure often followed, although it has been known for years that the one thing to avoid, if possible, is the occurrence of any discharge from the nose. Does not common-sense suggest that the right principles that should govern the methods of discharging patients are to “ harden,” or re-acclimatise them to the conditions of outside life, during the last part of their stay in hospital : to give up the hot bath immediately before leaving, and by having the hospital near their homes to avoid long journeys by ’bus or train, especially in inclement weather ? There are certain patients who cannot be submitted to the preparation-for- home treatment already outlined. I refer to those suffering from chronic ailments^ from some previous illness or accident which confines them to their beds ; or from some complication of scarlet fever, such as kidney or heart affections, which do not clear up, but leave the organs permanently damaged. The plan usually adopted in dealing with these cases is as follows : They are washed as thoroughly as possib]e on the day of discharge, or on the previous evening, in the latter case being kept for the night in an uninfected room. Then, carefully wrapped in blankets, they are sent by ambulance, either to some general hospital or infirmary or to their own homes. I have no statistics on the subject, but as far as I am aware, these patients do not spread infection afterwards, although they may have been kept entirely in an acute ward, and never allowed out of doors. Does this invalidate](https://iiif.wellcomecollection.org/image/b30300332_0405.jp2/full/800%2C/0/default.jpg)
