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exercised in correctly diagnosing suspicious or doubtful cases.
Unfortunately, as you are probably aware, Smallpox in its various
modified forms is, at times, extremely difficult to diagnose, and in
this way the disease may spread. To prevent this, I shall be glad
if you will kindly advise me of any suspicious or doubtful cases
which you may meet with in your practice, more especially cases
which may be mistaken for Chickenpox, etc. I will gladly see
them in consultation with you, if you wish it, and will kindly let me
know. Do not hesitate to make use of me at any time.
I need not add that any information which you may send will be
onsidered strictly private,
Yours faithfully,
Joseph Priestley.
Notification of Chickenpox.
In view of the ready response to this letter by the medical men
throughout the Borough, it was not thought necessary to go to the
needless expense of making, temporarily or permanently, Chicken-
pox a compulsorily notifiable disease, as suggested by the Local
Government Board in a letter dated December 27th, 1901. It
is true that modified Smallpox cases are frequently mistaken by
medical men for Chickenpox, and that in a few instances persons
desiring to evade the obligation to' report cases of Smallpox to the
Sanitary Authority may declare such cases of Smallpox to be cases
of Chickenpox. On the other hand, for compulsory notification
of Chickenpox to be of use, the Medical Officer of Health should
have the power to visit and examine every case notified, and the
difficulties in the way of this being carried out practically are
obvious. Several other Metropolitan Borough Councils, whose officials
had not arranged with the medical men practising in their re
spective Boroughs in the same way as the Lambeth Borough Council
had,were in favour of the compulsory notification of Chickenpox
throughout London, and the London County Council, on January
28th, 1902, with the approval of the Local Government Board,
under Section 55 of the Public Health (London) Act, 1891, made
an Order, which came into operation on February 7th, 1902, making
Chickenpox a notifiable disease throughout the administrative
County of London for a period of three calendar months, on the
ground of emergency owing to the prevalence of Smallpox in London,
and the fact that the failure in many cases to distinguish between
Chickenpox and Smallpox had led to the spread of the
latter disease. The notification is dual, viz.: a notice by the
head of the family (or other responsible person), and a certificate
by the medical attendant; and the penalty for non-compliance is
a fine not exceeding forty shillings.
This Order was extended on April 22nd, 1902, for a further
period of six months from May 7th, 1902. Up to the end of
August, 1902, there have been notified within the Borough of
Lambeth 988 cases as follows : —