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It will be seen that in the practices of midwives C, D, E and F two cases occurred so close
together in point of time that the possibility of the midwife having conveyed the infection from one
case to the other cannot be precluded, although, of course, these particulars do not in any way
prove such a suggestion.
In fairness to women engaged in maternity practice, it must be pointed out that the large
number of midwives with two or more cases compared with the fact that only one doctor had two
cases does not necessarily indicate that the midwives are not so careful as the doctors in regard to
the preventive measures which can be taken against this disease. The number of medical men
attending confinements in the Borough is so large that the 53 ophthalmia cases distributed
amongst them would not give one per doctor, whereas the number of women engaged in maternity
practice is small in comparison and several of them must of necessity have two or more of the
53 cases on their lists.
Every one of the 53 notified cases has been finally reported as cured without any appreciable
loss of vision.
The very gratifying results of treatment are largely due to the excellent arrangement which
the Borough Council have entered into with the Kensington District Nursing Association, under
which the nurses of the latter authority carry out treatment at patients' homes prescribed by any
doctor, when requested to do so by the Medical Officer of Health.
No less than 48 of the 53 cases were attended by the Kensington District Nursing Association's
nurses and 8 were admitted to some hospital or the Kensington Infirmary immediately the disease
developed or after they had received some attention by the Association's nurses.
Quite apart from the intense pain and suffering associated with this disease and the possible
tragedy to the child of blindness for life, there is the economic side to be considered. The charges
on rates and taxes for the education and maintenance of one blind person throughout life must
represent an enormous sum and, in view of the fact that more than 30 per cent. of the children in
blind institutions have lost their sight as a result of ophthalmia neonatorum, the grant of £100 per
annum to the Kensington District Nursing Association by the Council must be regarded as an
economy of the wisest kind.
There was one case of ophthalmia in the month of August in regard to which no notification
was received and, when the facts came to my knowledge in December, it was found that the sight
of one eye was completely lost and that of the other seriously damaged. The Council instituted
proceedings against the medical practitioner for having failed to notify this case and he was fined
£5 and one guinea costs. At the hearing before the Magistrates, the Town Clerk made it clear that
it was not suggested that the doctor's treatment of the case was in any way at fault but that
proceedings had been instituted with a view to securing more efficient notification of this and other
notifiable diseases.
Pneumonia.—One hundred and forty-seven cases of this disease were notified, 124 being certified
to be suffering with primary pneumonia and 23 with influenzal pneumonia.
Malaria. —Twelve cases of this disease were notified, and investigation revealed that each
patient had been a soldier who had contracted the disease whilst abroad during the recent War.
Dysentery.—Four cases of this disease were notified. Particulars of each case are as
follows:—
1. Male. Aged 63. Contracted bacilliary dysentery on War service in the Near East.
Has died since notification.
2. Male. Aged 32. Contracted amoebic dysentery in India during the War. Now well,
and engaged in motor-car trade.
3. Male. Age 31. Contracted amoebic dysentery on War service in Mesopotamia. Has
died since notification.
4. Female. Aged 3. Bacteriologist failed to find amoebae, cysts or bacilli of dysentery,
but the case was notified on clinical evidence. The child has now left the
Borough.
Other Notifiable Diseases.—With the exception of tuberculosis, which is dealt with in a separate
section, no notifiable infectious diseases, other than those referred to, were notified during the
year.
ANTHRAX FROM SHAVING BRUSHES.
When it became known, early in 1920, that the occurrence in London of cases of anthrax in
man had been traced to the use of contaminated shaving brushes imported from Japan, the
Kensington Sanitary Inspectors visited all retail establishments in the Borough where shaving
brushes are sold, and seized several hundred of Japanese origin.
The Chief Sanitary Inspector personally conveyed the brushes back to the wholesale dealers
from whom they had been bought, and gave a warning in regard to the danger persons incurred in
using them. On the occasion of the last visit to the wholesale shops, his suspicions were aroused
that these returned articles were being sold at low prices to street hawkers and. in view of this, a
number of brushes subsequently collected in Kensington were retained in the Public Health
Office.
The facts were brought to the notice of the Council, and I was authorised (1) to destroy the
brushes collected and also any suspicious brushes which may be collected in the future and (2) to
issue certificates of destruction to the retail owners, on which these tradesmen can claim compensation,
at the rate of wholesale prices, from the Borough Treasurer. This seems to be the only safe
measure to adopt.
The importation of Japanese shaving brushes has been prohibited by an Order in Council
issued in 1920.