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Cases in Groups (c) and (d) require special attention. Most of these cases are children of poor
parents who either cannot afford to pay for a doctor or can pay for a first visit but cannot continue
to pay for subsequent visits. Cases in Group (d) include children of parents who, owing to poverty
or negligence, fail to obtain medical assistance until the child is moribund.
Arrangements are made by the Women Health Officers for nursing assistance to be rendered
to cases in Groups (c) and (d) immediately upon ascertaining that such is required. Medical
assistance is also obtained from the Board of Guardians or the Council's part time Medical Officer.
In the event of a severe outbreak of this disease occurring, or at such other time when there
may be any undue pressure of other work to be carried out by the nurses of the District Nursing
Association, the Infant Welfare Centres have indicated that they are prepared to allow their staffs
of trained nurses to assist in the home nursing of this disease.
The Metropolitan Asylums Board, at the request of the Council, have reserved a number of
beds in their hospitals for the treatment of cases of this disease specially recommended by Medical
Officers of Health. Patients are also admitted to the wards of St. Mary Abbot's Hospital. It is
unfortunate that many of the cases sent to the latter institution are moribund on admission.
Medical Assistance.
For the months of July, August and September in 1924 and June, July, August and September
in 1925, the Council retained the part time services of Dr. Ronald Carter, who has made a special
study of zymotic enteritis. Dr. Carter, during these months, paid periodical visits to the various
Infant Welfare Centres, when he was consulted in reference to difficult cases. He also saw cases in
their homes which were not attended by other doctors.
In 1924, Dr. Carter prepared for routine use a scheme of treatment which included intestinal
lavage, and in the Spring of that year he gave addresses to Health Officers, Voluntary Workers
and Sisters of the Infant Welfare Centres, Nurses of the Kensington District Nursing Association
and others who were to co-operate with him in the Council's scheme for dealing with this disease.
Shortly before the re-introduction of the scheme in 1925, Dr. Carter gave a further address to these
workers. He has worked in close co-operation with the voluntary agencies in Kensington and with
the Medical Superintendent of St. Mary Abbot's Hospital.
Record of Treatment carried out under the direction of the Council.

The year 1924 was a very bad one in which to test the value of the scheme. The Summer was
cold and wet and did not favour the spread of zymotic enteritis. Few cases occurred and, therefore,
it was impossible at the end of that year to give any definite opinion as to the success of the Council's
effort.
The year 1925, however, was very different from the climatic point of view. The months of
May and June were fine and hot; indeed, rarely has this country enjoyed two more perfect Summer
months. But such months favour the spread of zymotic enteritis and, therefore, there was ample
opportunity for the scheme to be thoroughly tried out.
It is satisfactory to be able to record that not one of the cases attended by Dr. Carter throughout
the two years proved fatal and not one attended by the Kensington District Nursing Association
or the Infant Welfare Centres died in 1924. There was one fatal case amongst those nursed by the
District Nursing Association in 1925.
Dr. Carter, as a result of his experience, is of the opinion that the best results are obtained
when treatment is begun within twenty-four hours of the commencement of the attack; but this
unfortunately does not always mean when the case is notified. Some of the poorest parents will
not call in a doctor because they cannot pay his fee, and wait until the case is in extremis before
seeking medical aid.