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CEREBRO-SPINAL FEVER ("SPOTTED FEVER").
The Local Government Board, on 24th August, addressed a circular letter to Sanitary Authorities
throughout the Kingdom with reference to this disease, in which it was stated that, so far
as they had been able to ascertain, there was no ground for the apprehension that the disease had
newly extended to, or had been developing in, this country; it having recently been somewhat
extensively prevalent in Central Europe and in America. The Board thought it probable that
cerebro-spinal fever was, at that time, "not more prevalent in this country than it had been from
time to time during the past quarter of a century." Nevertheless they considered that Sanitary
Authorities should be on the alert to detect the presence of the disease in their districts, and to
this end the Board had issued a Memorandum, prepared by their Medical Officer, dealing generally
with the characteristic symptoms of the disease, and especially with its minor and anomalous
manifestations. The Board described the steps it would be desirable to take in the event of the
discovery in any district of groups of cases of illness which might possibly be of the nature of
cerebro-spinal fever, and stated that in such an event, they would be prepared to render the Sanitary
Authority such advice or assistance as in the circumstances might appear to be necessary;
and in the event of the Sanitary Authority desiring that the dieease should be made compulsorily
notifiable in their district, the Board would be prepared to consider an application for their
approval to a resolution of the Authority for a temporary extension of the provisions of law to
the disease. It may be mentioned that I received a notice of the occurrence of a case of what
was thought to be cerebro-spinal fever in a young man. The patient was removed to hospital.
A post-mortem examination clearly proved that the illness was not of the nature supposed. But
disinfection had been done, and all other necessary measures of precaution were adopted.
THE PREVENTION OF CONSUMPTION.
The assemblage at Paris of the seventh international congress on tuberculosis,
naturally recalled the Congress held in London in 1901, and the great stimulus it gave to efforts
for combating this, the greatest scourge of the human race in the occidental world. The Council
appointed two delegates to represent them at the Congress, whose report, and certain other
communications, were referred to the Public Health Committee. The report of the Committee
(printed in my annual report for 1901—page 39) set out certain of the recommendations of the
Congress, to wit—
Voluntary notification of cases of consumption attended with tuberculous expectoration—the
main agent for the conveyance of tuberculosis from man to man;
The supply to consumptives, by hospitals and dispensaries, of pocket spittoons, with
a view to the suppression of the dangerous habit of indiscriminate spitting;
The supply to consumptives, by these institutions, of printed instructions with regard
to the prevention of consumption;
The provision of sanatoria as an indispensable part of the measures necessary for the
diminution of tuberculosis; and
The provision of anti-tubercular dispensaries, as the best means of checking tubercular
disease among the industrial and indigent classes.
Premising that time would be required for giving effect to the recommendations, the Committee,
as regarded action that might be taken by the Council, recommended (inter alia)—
1. (a) The adoption of a system of voluntary notification by medical men of cases of
sumption attended with tuberculous expectoration ;
(b) Payment to medical men of the customary fee for notification of such cases, and
(c) An arrangement for bacteriological examination of expectoration suspected to be
tuberculous.
2. The further circulation of the Council's leaflet on "The Prevention of Consumption."
3. Disinfection of houses after the occurrence of fatal cases of consumption, and after
the removal of consumptives, and
4. An appeal to the Local Government Board to give effect to the recommendation of the
Conference of delegates of the Metropolitan Poor Law Authorities (October, 1900) for
the provision of Sanatoria.