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I have no evidence that this procedure has been instrumental in
spreading the disease.
Up to 1907 it was the practice of the Public Health Committee
to have disinfection carried out at all houses where we had received
information, no matter how belated, of the existence of measles.
Since that year, however, the practice has been discontinued, with
apparently no untoward results, your Officers only attending on a
special request being made.
The deaths from erysipelas were the same in number as last
year, but of the 7 cases, 3 occurred between fifteen and sixty-five,
and the other 4 within the first week of life. In the previous year
3 of the fatal issues were in those over sixty-five.
Of puerperal fever and the septic diseases of childbirth which
are classified with it there were 5 fatal instances, 2 more than
last year. In each case the midwife in attendance, as well as any
other person who might have been in attendance, on the woman,
have been required to see me in order that I might be certain that
they had taken all the necessary precautions to avoid spreading the
disease to others.
There were 2 notifications of epidemic cerebro-spinal meningitis,
both of which were fatal, both in infants under one year. Enquiries
were in all instances made as to contact with any other persons
who had been suffering from either this disease or from such
symptoms, such as nasal catarrh, and which are occasionally
associated with its development, but in each case without any result.
No notifications were received of plague, cholera, or typhus
fever.
The various forms of tuberculosis caused 411 deaths, as compared
with 465 in 1907, a number which is calculated to well bring
home to us the extent of the disease and the imperative necessity of
seriously examining any and every plan for its lessening. Out of
the 411, 297 were due to phthisis, as compared with 333 in 1907.
The view which ascribes to pulmonary tuberculosis a person-to-person
infectivity of great power, is very generally held among
Public Health administrators, perhaps, indeed, to a greater extent
than among practising physicians, but this theory seems hardly
warranted by the observed facts.
On this supposition the occurrence of secondary cases in houses
where lives a person attacked by phthisis should be a matter of
common observation; but it has not been so, at all events so far as
inquiries in this Borough go to prove.
It might be urged that this non-occurrence is due in recent
years to the precautions taken by sufferers to avoid the chance of
infection to others, but if disinfection, &c., have been so powerful in
the abolition of such secondary cases, it seems reasonable to ask
why they have not been equally successful in bringing about a
greater fall in the death-rate than has actually occurred.
It must be apparent to all that the practice of regarding the
disease as infectious has very largely prevailed in Great Britain,
and the precautionary measures generally adopted, while not being