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Half the cases which occurred were notified in the months of August, September and October,
which were also the months of maximum prevalence for the Metropolis as a whole. Three cases
were notified between December 2nd and December 30th, but of this number one should be allotted
to the period of greatest prevalence since the history shows that the illness began on October 26th.
PUERPERAL FEVER.
Seven cases of puerperal fever were notified during the year and of this number four proved
fatal. Three patients were attended in the first instance by midwives and four by doctors. Of the
midwives' patients one developed eclampsia within twelve hours after delivery and died within two
days; the case was obviously not one of puerperal fever. In the second case which also terminated
fatally, instrumental delivery of a dead foetus was effected by a medical practitioner. The third
patient suffered from a very mild attack of puerperal fever and made a good recovery. Of the
doctors cases two were due to the retention of portions of the after-birth, and one to the instrumental
delivery of a decomposed foetus. Of these three cases two died. The fourth case was mild and
made a good recovery. In no instance did the same midwife or doctor or nurse attend more than
one of the patients notified during the year.
Acute Poliomyelitis.—Acute poliomyelitis was made compulsorily notifiable in London for
the first time on March 13th, 1911. No instance of the disease having occurred in Kensington has
been brought to the notice of the Council, but 69 cases have been notified elsewhere in the
Metropolis. Acute poliomyelitis is a disease which occurs chiefly in childhood, attacks the
central nervous system and gives rise to the condition known as infantile paralysis. In severe
attacks which do not end in death, the patient suffers through life from wasting and paralysis of one
or more of the limbs. As a rule the cases that occur are sporadic in their incidence and show no
tendency to be followed by others in the same neighbourhood, but within recent years epidemic
outbreaks of fatal forms of poliomyelitis have been reported on the Continent and in America.
In the summer and autumn of the year 1911, 218 cases occurred in the counties of Devon and
Cornwall and gave rise to no less than 42 deaths. The fatality was thus equivalent to close on 20
deaths among every 100 cases as compared with a fatality of less than 10 per cent. among persons
who suffered from diphtheria in Kensington. When it is borne in mind that out of the 176 patients
who survived a large number will suffer thoughout life from varying degrees of paralysis in one
or more limbs, it becomes evident that acute poliomyelitis must be regarded as a very serious
disease. From Dr. Reece's report to the Local Government Board on the outbreak in the SouthWest
of England it also appears that in at least eleven houses more than one person was attacked,
whilst five instances are recorded in which the number of persons falling ill in a single house
exceeded three. There are thus grounds for the belief that the disease may spread by infection
from person to person. As a preventitive measure disinfection is accordingly indicated, but the
most urgent need is further knowledge as to the natural history and prevalence of the disease.
With this end in view, acute poliomyelitis has been made compulsorily notifiable in London and a
large number of other sanitary districts in England.
Cerebro-Spinal Fever.—Cerebro-Spinal Fever and poliomyelitis possess certain features in
common, which render their distinction, particularly in fatal cases, a matter of some difficulty. The
evidence available does not, however, support the suggestion sometimes made that the two diseases
may appear together in epidemic form at the same time and in the same locality. During the year
102 cases of cerebro-spinal fever were notified in London. Only one case was notified in Kensington.
The patient died and post mortem examination proved that the cerebral symptoms had been
due to tuberculosis of the meninges of the brain.
OPHTHALMIA NEONATORUM.
Ophthalmia in the newly-born is a frequent cause of total blindness or seriously defective
vision. In the most virulent form the disease is generally due to gonorrhoea in the mother. For
the prevention of blindness the adoption of two measures is necessary. The first and most effective