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84
Failure to recognise cerebro-spinal fever is also apt to happen
when the malady is of the "fulminant" variety, in which death
ensues rapidly. In these instances the disease has been mistaken
for typhus fever, idiopathic tetanus, or malignant measles.
An important aid to diagnosis may be found in examination
of cerebro-spinal fluid, withdrawn from the lower part of the spinal
canal by lumbar puncture, for the presence of the "diplococcus
meningitidis intracellularis" of Weichselbaum; a micro-organism
which is now generally regarded as the specific cause of cerebrospinal
fever.
Whether cerebro spinal fever is spread by direct infection from
person to person is matter of uncertainty, indeed, there is as yet
no definite knowledge as to the way or ways in which its transmission
may take place. Since, however, the possibility of direct
personal infection cannot, on the evidence available, be excluded,
it will be wise to endeavour to secure, as far as practicable, the
isolation of the sick from the healthy. It will also be advisable to
apply suitable measures of disinfection to piemises that have been
occupied by the sick, and to articles that may have been in relation
with them.
In view of the fact that the presence of Weichselbaum's
diplococcus has been observed in the mucus of the nose and mouth,
not only of the sick, but also of those attending on the sick, there
may be advantage in resorting to periodical ablutions of the nasal
and buccal passages of the sick and their attendants.
W. H. POWER,
Medical Officer.
Local Government Board,
July 1905.
Home Office,
Whitehall,
26th July, 1907.
Sir,
I am directed by the Secretary of State to enclose, for the
Information of the Council, a copy of a new Home Work Order