Excerpt from Sixth Annual Report of the Provincial Board of Health of Ontario: Being for the Year 1887

We have to refer especially to diphtheria, which has been present in. Many populous centres and which, as referred to in the last Annual Report, had in the last quarter of 1886 attacked the inmates of one of our public institutions, to the extent of creating general alarm and directing the attention of the Board to the discussion of' what measures ought to be taken for dealing with a disease so fatal in its consequences, while so insidious in its onset and appearance. The recommendations then adopted by the Board were not sanctioned by an Order in Council, but the Statutory enactments of' the Legislature of 1887 placed the Board in the position of having to enquire into the measures which Local Boards were adopting for stamping out this and other scheduled diseases, appearing amongst them. The powers contained in section 6 of said Act are of a character so important, that your Board discussed the question of how far the clause demanded enquiry into those facilities which are now deemed necessary to be constantly at hand for isolating first cases of zymotic diseases when they do appear. The following remarks by the efficient Medical Health Officer for Chelsea, London, England, puts the case as it appears everywhere most concisely regarding notification and isolation. Speak ing about scarlet fever, which has recently prevailed in parts of London, he says, In the case of scarlet fever the complete separation of the sick from the healthy is the most important precautionary measure. We have had an illustration of the advantages of isolation in this parish during the present epidemic. In the poorest parts the parents have almost all been willing to let their children be removed to the hospitals, which are maintained for the purpose of isolating cases of scarlet fever which cannot be isolated at home the result has been that we have been comparatively free from the disease. But, on the other hand, in the outlying part of the parish, which comprises the Queen's Park estate, where the houses are of a superior class to those I have referred to, a large propor tion of the cases have been treated at home. The circumstances of the family have been such as to preclude the possibility of anything like complete isolation, and as a natural consequence the disease has prevailed far more extensively in that district. The isolation of a person may be carried out in three ways. In a large house a separate floor at the top may be devoted to the sick and the nurse, all communication practically being cut, off. In a smaller house, where such is impossible, the patient can be kept at home if the others who are not infected be provided for elsewhere. This plan is, however, imperfect and seldom practicable. The third alternative is to send the case to a hospital, where in the vast majority of cases isolation can be far better carried out than at home.

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