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1027
34

The deaths during the year numbered 6 and were equal to the very high rate
of 86 per cent, of the cases notified.
Public Health (Pneumonia, Malaria, Dysentery, etc.) Regulations, 1919.

DYSENTERY. (Tollington Ward.)
During the year under review it will be noted that there were five cases of
dysentery. These occurred in one family in Tollington Ward. My attention was
drawn by a medical practitioner to three children who were ill in a family, and at
his request they were seen by me. At the same time 1 had the question of the
food partaken gone into and the drains inspected. The drainage was found to
be defective. At the time of my visit there was also another child isolated in
an ante-room. 1 was of opinion that the three children were suffering from
Dysentery, and with the concurrence of the medical attendant they were removed
to hospital the next day. The other child and the mother subsequently developed
the disease. Meanwhile the stools were examined and the " Flexner " Bacillus
of Dysentery found, confirming the diagnosis. The bacteriological history is
interesting. The clinical diagnosis was confirmed in all cases of this family sent
to hospital by serological or bacteriological means. An organism of the
"Flexner" type of the bacillus dysenteriae was isolated from the mother, a
daughter and a son, whilst another daughter and son gave serological evidence
of suffering from the same infection. The organism in one case gave reactions
of a "W" strain of Flexner, while in another case reactions of the "X" "V"
or "W" type were given.
The subsequent history of these cases as mentioned is interesting as showing
that in a small house such cases cannot be adequately attended to. First of all
we had the three cases, then another child taken ill a few days afterwards, and
then a week afterwards the mother, but we think the mother may have been