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Outbreaks of this sort might cause a great deal of trouble were the nature of the
complaint not discovered, but the School Board appointed early in 1903 an assistant medical
officer to look after the infectious diseases in the various schools under their charge, and in such
cases as the above he at once visits the school and ascertains the extent to which it is affected
and advises on preventive measures, at the same time communicating with the Medical Officer
of Health.
Relapsing Fever.
On May 20th a notification was received of the above disease, viz., R.L. (f.) 11 years, of
Marcia Road. The medical attendant kindly communicated the following history. " The first
time I saw her, her temperature was 105 F., with usual febrile disturbances which was
maintained for two or three days when a crisis occurred, accompanied with profuse sweating and
diarrhcea, the temperature remaining normal for a few days then shooting up again to 105 F.
In a few days another crisis occurred similar to the first, the temperature remaining normal for
a few days then shot up again when I reported the case."
He further states that there were petechia and a well developed roseolous rash all over her
like typhoid.
This disease is rarer nowadays than typhus with which it is generally associated, but the
above history shows the advantage of still retaining it 011 the list of dangerous infectious
diseases.
On admission to hospital the Medical Superintendent informs me her temperature was
99.6 F., but rose in the evening. Her blood gave the Widal reaction and the spirillum of
Relapsing Fever could not be found. This case must therefore be considered as one of typhoid
with an abnormal onset resembling Relapsing Fever.
Notification of Phthisis.
I gave a detailed account in last year's Annual Report of the steps which led up to the
voluntary notification of phthisis in Bermondsey and I purpose now giving a short account of
the result.
In April, 1903, the permission of the Borough Council was obtained to make phthisis
voluntarily notifiable.
The following is the form of notification adopted. It is a modification of one already
some time in use in Finsbury:—
THE PUBLIC HEALTH (LONDON) ACT, 1891.
VOLUNTARY NOTIFICATION OF PHTHISIS.
CERTIFICATE OF MEDICAL PRACTITIONER.
To the Medical Officer of Health .
TOWN HALL, LOWER ROAD, S.E.
3 bercbs certify that in my opinion the person hereinafter named is suffering from
Phthisis (with inuco-purulent discharge of infective sputum) ; and I farther certify the following
particulars in respect of such person :—
I
Name in fall of the Patient
Age of Patient
Sex
Full Postal Address of House of which
Patient is an Inmate
If the Patient is an Inmate of a Public
Institution
Place from which the Patient was brought *
and date of Admission
State whether disinfection be desired at
the time of notification or periodically,
or not at all
Whether the case lias occurred—
(a) In the private practice of the Practitioner
certifying or
(i) In his practice as Medical Officer of a Public
Body or Institution ; and if so, of what Body
or Institution
Dated the lay of 1 ) 190
(Signed) — Medical Practitioner.
Address of Person signing
Note.—This certificate is a voluntary one. There will be 110 official interference as the result of notification
with your patient, either at home or in connection with his occupation, the steps taken being confined to the distribution
of leaflet relating to the general hygiene and methodg of preventing the spread of tuberculosis, to enquiries by
the Medical Officer of Health where deemed necessary, the remedying of sanitary defects, and disinfection when
required. No case should be notified without the consent of the patient. Cases should not be notified which have
been another practitioner, unless there has been a change of address in the meantime.
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