View report page

13
Under the Anti-Toxin Order, 1910, local authorities are empowered to supply diphtheria
anti-toxin to medical men for administration to those of their patients who are unable to pay for
the supply. This Order enables the doctors, without cost to themselves, to administer anti-toxin
to poor patients before they are admitted to hospital, with the result that they stand an enhanced
prospect of recovery. In 1920 the Borough Council supplied 178,000 units of anti-toxin for 43
patients at a cost of £18 6s. Practitioners are offered a fee of five shillings for administering
anti-toxin to poor persons who cannot pay for medical assistance, and during the year the fees paid
totalled £2.
Enteric Fever.—Twenty-four cases of this disease were notified, 13 being removed to hospital.
The cases notified in the three preceding years were 20, 11 and 16. There was only one death
from this cause against 5, 1 and 2 in the three preceding years.
All except three of the twenty-four cases were notified from the southern division of the
Borough. This heavier incidence in South Kensington is not usual with other infectious diseases,
and it is probably accounted for by the fact that water supplies and sanitary arrangements in
London generally are very good and that most persons contracting typhoid fever are infected
outside the Metropolis. It will be admitted that the residents in the southern portion of the
Borough leave the London area more frequently than those in the north and, consequently, are
more exposed to infection by reason of the fact that many outside London districts do not enjoy
the same sanitary efficiency.
Of the cases notified from the south of the Borough, three had recently returned home from
the Continent, and in five others there was a history of the patients having been out of London
quite recently, together with some evidence that the infection had been contracted whilst they
were so absent from home.
A study of typhoid fever over the last 40 years reveals the remarkable way in which the
disease appears to be gradually disappearing from this country. A very steady decrease in the
number of notified cases has taken place during the period in which the water carriage system
of sewage disposal has been extensively installed throughout the country.
Erysipelas.—Sixty-eight cases were notified during the year, 25 of which were removed to
hospital. The cases notified in the three preceding years were 69, 48 and 79. There was only
one death from this cause, the deaths in the three previous years being 5, 5 and 3.
Continued Fever.—One case of this disease was notified, and was treated at home.
Puerperal Fever.—Nine cases of this disease were notified, against 2, 4 and 11 in the three
preceding years. There were 5 deaths, against 1, 0 and 7 in the three previous years.
Cerebrospinal Fever.—Five cases of this disease were notified, particulars of which are
appended:—
1. Female. Aged 6 years. Attacked January 14th—treated at home and recovered.
2. Male. Aged 4 years. Attacked January 24th—removed to hospital and recovered
with slight paralysis.
3. Male. Aged 6 weeks. Attacked April 1st and died April 3rd.
4. Male. Aged 7 months. Attacked June 28th—removed to hospital—a bacteriological
examination was made with a positive result—returned home nearly blind.
5. Female. Aged 1½ years. Attacked December 13th—was removed to hospital, and
recovered.
The notifications in the three preceding years were 17, 14 and 6, and the deaths 10, 6 and 1.
Encephalitis Letliargica.—Five cases of this disease were notified, particulars of which are
subjoined:—
1. Female. Aged 46 years. Attacked May 3rd. The family having removed from the
Borough, the ultimate result of the case cannot be ascertained.
2. Male. Aged 42 years. Attacked May 26th, and died June 14th.
3. Male. Aged 31 years. Attacked November 8th. This patient was treated at home
and ultimately made a good recovery.
4. Female. Aged 37 years. Attacked December 5th, and was removed to St. Mary's
Hospital, where she died on December 20th.
5. Male. Aged 17 years. Attacked December 12th, and was removed to the
western Hospital, where he recovered.
After careful enquiry it was found that there was no connection between these five cases, but
it should be mentioned that in February, 1921, a case was notified from the block of flats from
which case No. 4 was removed in December. Case No. 4 was a maid in one flat, and the patient
notified in February was a lady occupying another close by. Very thorough investigation revealed
the fact that the only possible place of contact would be in the electric lift, and the evidence
obtained indicated that it would be most unlikely that these two persons would ever be in the lift
at the same time.
At present this disease is making its appearance all over the world—a fact which has been
noted by the Committee of the Office International d'Hygiene Publique, Paris, 1920, whose statements
regarding the malady include the following:—
In France 321 cases have been reported, the deaths being about 30 per cent.
In Denmark, 58 cases have occurred since July, 1919.