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Enteric Fever.—Twelve cases of this disease were notified, 9 being removed to hospital. The
cases notified in the three preceding years were 24, 22 and 18. There were two deaths from this
cause, against 1, 3 and 2 in the preceding years. Six of the 12 cases were notified from North
Kensington and 6 from South Kensington. In one case the disease was contracted on the
Continent, and in three others the patients had paid visits to country places just prior to the
date of attack. Six of the cases were notified as para-typhoid fever.
Erysipelas.—Sixty-seven cases were notified during the year, 32 of which were removed to
hospital. The cases notified in the three preceding years were 68, 82 and 44. There were
four deaths from this cause, the deaths in the three previous years being 3, 1 and 1.
Puerperal Fever.—Fifteen cases of this disease were not ified, against 9,8 and 10 in the three
preceding years. There were 7 deaths, against 5, 3 and 6 in the three previous years.
As the patients contracting this disease are in the child-bearing period of life, a fatal case does
not mean only the death of a woman in her prime, but it frequently results in a family of small
children being deprived of that maternal care and affection which is so essential to their welfare.
Indeed, there is no other disease which is likely to be followed by more disastrous consequences to
the family, and when it is realised that puerperal fever is very largely both preventable and curable,
it must be admitted that no local authority should rest content until everything has been done in
the direction of prevention and treatment.
On notification of a case of this disease, the Health Officers immediately pay a visit to the
home, and endeavour in every case where practicable to secure removal to hospital. This step is
taken because it is more satisfactory to carry out any necessary surgical treatment in a hospital,
and also because it is not desirable that district midwives and nurses, who may be called upon to
attend other confinements, should nurse a case of puerperal fever which is an infectious disease.
Of the 15 cases notified, 5 were removed to St. Mary Abbot's Hospital, 5 to the Western
Metropolitan Asylums Board Hospital, 2 were treated in nursing homes, and 3 remained for
treatment in their own homes. There were 5 deaths at St. Mary Abbot's Hospital, none at the
Western Hospital, one in a nursing home, and 1 in her own home.
Encephalitis Lethargica.—Three cases of this disease were notified, particulars of which
are subjoined:—
1. Female. Aged 40 years. Notified January 25th. Recovered.
2. Female. Aged 10½ years. Notified March 21st. Recovered.
3. Male. Aged 42 years. Notified March 26th. Died July 15th.
Ophthalmia Neonatorum. —This disease, which is an inflammation of the eyes of newly-born
infants, is in most cases due to the entrance of gonorrhœal infection into the eyes during the
process of birth. It, however, sometimes results from the entrance of other forms of disease
germs at the time of birth, and infection may also occur at any time afterwards if disease bacteria
are brought into contact with the child's eyes by the unclean fingers of the mother or nurse. In
neglected cases ulcers may form on the outer membrane of the eye, and partial or complete loss of
vision may result. In view of the serious consequences of neglect in treatment, ophthalmia
neonatorum was made compulsorily notifiable in 1914.
Twenty-one cases were notified during the year, the numbers in the preceding years being
53, 33 and 20.
The Women Health Officers take great pains to obtain the best possible treatment. Every case
is visited on the day that notification is received in the Public Health Department and visits are paid
daily, if necessary, until the child is cured. Attempts are made to secure the child's and mother's
admission to hospital and, if these are unsuccessful, arrangements are made for a nurse from
the Kensington District Nursing Association, who has been trained in ophthalmia treatment, to
visit the home as frequently as is necessary to carry out the nursing instructions of the medical
attendant. Care is taken that a medical man is in attendance on every case.
Three of the 21 notified infants were born and treated in the St. Mary Abbot's Hospital,
12 were admitted to the Metropolitan Asylums Board Ophthalmia Hospital, 4 were treated in the
out-patient departments of hospitals and the remaining 2 were attended at home by general
medical practitioners.
It is the duty of midwives to report all forms of inflammation of the eye, even when the
condition is not ophthalmia neonatorum, and these cases, in addition to pure ophthalmia cases, are
also dealt with by the Kensington District Nursing Association. In 1923, the ophthalmia
neonatorum and inflammation of the eye cases attended by the nurses numbered 61 and the
number of home visits paid in connection with these cases was 1,131. These visits average 19 to
each of the 61 patients, and indicate the great amount of trouble taken with this disease. The
visits paid by the Council's Women Health Officers are not included in the 1,131.
Of the 21 cases notified, the right eye alone was affected in 2 cases, the left eye alone in 2
cases, and both eyes in 17 cases. In one case the child died of another complaint whilst being
treated for ophthalmia, and in every other case the disease has been cured without any damage to
sight.
There was a similarly splendid record in 1922.
In 1921, 31 of the 33 cases notified were cured without damage to sight. In one of the remaining
cases, where the child was born and treated outside the Borough and was not under the supervision
of the Council's Health Officers, there was complete blindness in one eye; and in the