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37
27 cases; encephalitis lethargica, which increased from
2 to 21 cases, and pneumonia, which increased from 218
to 326 cases.
The two most serious increases are those of encephalitis
lethargica and pneumonia. Noticeable falls in
the prevalence of infectious diseases are found in the
case of scarlet fever, which has fallen from 466 to 360,
tuberculosis of the respiratory system, which shows a
fall from 319 to 270, and epidemic diarrhoea, which
shows a fall from 79 to 40. Full particulars of these
notifications, arranged according to disease, ward and
age, will be found in Table IV, page 42. In connection
with diphtheria and scarlet fever, I have had special
note made during the year as to whether the diagnoses
as notified were confirmed in the fever hospitals to
which the patients were admitted. As the result we
find that 63 notifications of diphtheria, or 24.3 per cent.
of the total cases, and 29 notifications of scarlet fever,
or 8.03 per cent., were not confirmed in hospital. The
percentage of apparently erroneous notifications regarding
diphtheria has increased from 16.2 per cent. in 1923
to 24.3 per cent. in 1924. I am of opinion that part
of this was the result of a prosecution which took place
in Gloucester during the year, when a medical man
was prosecuted for neglecting a case of diphtheria.
He was eventually acquitted, but undoubtedly it raised
fears in the minds of many general practitioners and in
my opinion led to them notifying diphtheria more
readily than they might have done had that prosecution
not taken place. It will be obvious that if a practitioner
notifies a case as diphtheria and has it removed to
hospital he can hardly afterwards be charged with
neglect, and provided he has used reasonable care in
arriving at his diagnosis he is apparently on safe
ground.
There are four matters in connection with infectious
disease which it may be interesting to deal with in further
detail. They are as follows:—
Smallpox.—Although no case of this disease was
notified in the Borough during the year, nevertheless