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until May 7th, when he sprained his right ankle. Except for this
injury, however, he complained of nothing until the evening
of the following day, May 8th, when he was taken ill with
headache and other symptoms of fever. On the morning of
May 9th, he had a fit and became unconscious, in which
condition he remained until his death at 1.45 the same day.
His head was retracted, and the symptoms generally pointed
to cerebro-spinal meningitis.
No source of infection could be traced. An undoubted
case of the disease had occurred at Richmond some six weeks
before, but careful enquiry could trace no connection between
the two cases.
In view of the negative results of the bacteriological
examinations, the evidence that this case was really one of
epidemic cerebro-spinal meningitis, or "spotted fever" cannot
be regarded as conclusive; but every precaution was taken to
prevent a possible spread of the disease. The premises were
disinfected throughout, and the contacts kept under
observation. A memorandum by the Medical Officer to the
Local Government Board, describing the clinical features of the
disease, was circulated to all the medical practitioners in the
borough. Nine suspected cases of epidemic cerebro-spinal
meningitis were reported to me by medical practitioners, but
in every case the patient was found to be suffering from some
other disease.
Alcoholism.
Six deaths were returned as due to acute and chronic
alcoholism, 5 of the cases being males, and 1 a female. Twentyfour
deaths (males 13, females 11) were due to cirrhosis of the
liver, a disease which, in practically every case, is caused by
alcohol. This gives a total of 30 cases in which alcohol was
the cause of death, as against 31 in 1904, but there is no doubt
that this number greatly understates the real mortality from
alcoholism. Deaths really due to this cause are usually
certified under less invidious headings such as apoplexy,
Bright's disease, heart disease, &c.