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PREVENTIVE METHODS.
Notification. —If the prompt notification of every case of
Small-pox could be secured, it would be an easy matter to deal
with an outbreak. Unfortunately, many cases are not notified
at all, or not until the infection has spread. Some patients,
either innocently or designedly, do not seek medical advice,
and in other cases, although a doctor is seen, the clinical
features are so modified that the diagnosis of Small-pox is
not made. Fortunately, the medical men practising in the
Borough did not hesitate to avail themselves of such assistance
as I was able to give them in this respect. I was asked to
see 112 doubtful cases in all, 45 of which were Small-pox,
and the remainder other diseases, chiefly Chicken-pox.
The question of making Chicken-pox a notifiable disease
was discussed by the Health Committee, and it was decided
that this course should not be taken. On January 28th the
London County Council made an order, the effect of which
was to make Chicken-pox a notifiable disease over the whole
of the County of London. This order was renewed from
time to time, and finally expired on January 7th, 1903. The
County Council also appointed, in certain parts of London,
medical referees to whom medical practitioners could apply
for aid in the diagnosis of doubtful cases. This action of
the County Council was severely criticised by several of the
Borough Councils, who contended that the appointment of
medical referees was a matter for them, and that the County
Council, in making these appointments, was trespassing on
their preserves; but it is not easy to see how the County
Council's action prevented any Borough Council from
appointing as many medical referees as it liked. The two
gentlemen appointed to act in Battersea had had considerable
experience in Small-pox, and rendered valuable assistance.
In Battersea, at all events, the action of the County Council
was productive of nothing- but good. Every case notified was
promptly investigated by the Medical Officer of Health, and in
this way, by tracing the source of the disease, upwards, so
to speak, many other cases were brought to light.