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Puerperal Fever.—Thirteen cases of this disease were notified ; six were confined at home, six
in hospital and one in a nursing home. Four of the cases confined at home were subsequently removed
to hospital. In every instance the patient recovered.
Puerperal Pyrexia.—Twenty-one cases of this disease were notified, 17 of the patients being
confined in hospital and four in their own homes. Three of the four confined at home were
subsequently removed to hospital for treatment.
None of the notified cases proved fatal.
The council, as suggested by the Minister of Health, have provided facilities for expert assistance
in diagnosis and treatment for patients who are unable to secure this for themselves. In this connection,
l3r. A. Morris Johns, a specialist at Queen Charlotte's Hospital, was appointed to the position
of consulting gynaecologist and obstetrician some years ago. His services are available to any
general practitioner or midwife on request.
Pneumonia and Influenzal Pneumonia. —There are many forms of pneumonia, but the only
kinds notifiable are acute primary pneumonia and influenzal pneumonia. One hundred and seventyseven
notifications were received during the year, 143 patients being certified as suffering from acute
primary pneumonia and 34 from influenzal pneumonia.
The number of deaths from pneumonia was 160, and 34 deaths were certified to be due to
influenza.
Malaria.—Two cases of this disease were notified and investigations revealed that in each
instance the disease had been contracted abroad.
Acute Rheumatism.—Forty-eight cases were notified.
The eighth annual report on the working of the rheumatism scheme during the period
1st October, 1935, to 30th September, 1936, prepared by the medical officer of health and the physicians
in charge of the rheumatism centre, appears as appendix I to this report.
Cerebro-spinal Meningitis.—Six cases of this disease were notified, four of the patients being
females aged 1, 12, 19 and 54 years, and two males aged 1 and 10 years.
Three of the female patients died and the fourth was still under treatment at the end of the year.
With regard to the two male patients, the one aged 10 completely recovered, and the other moved
out of the district before full recovery.
Dysentery.—Seven cases of dysentery were notified. Two were of the amoebic type, and the
infection was contracted abroad. The remaining five patients suffered from bacillary dysentery,
the infecting organism being the sonne bacillus.
Four of the cases of bacillary dysentery were removed to hospital for treatment, and the
remaining one to a nursing home.
There were no deaths from the disease.
Zymotic Enteritis or Summer Diarrhoea.—Seventy-eight cases of zymotic enteritis were notified.
In considering the value to be attached to this figure two points must be remembered. First, the
disease is notifiable only in children under five years of age. Second, zymotic or infective enteritis
is sometimes difficult to distinguish from enteritis following errors in diet and other forms of this
disease which may not be infective ; doctors frequently notify enteritis, whether it be of the zymotic
variety or not, to be on the safe side, or in order that the facilities offered by the council shall be made
available in the treatment of the patient.
There were 43 deaths certified as due to diarrhoea, etc., and of these there were 36 children under
one year of age. Thirteen of the children under five dying of diarrhoea had been notified.
In 1924 the council adopted a scheme for the control and treatment of zymotic enteritis.
From 1924 until 1934, the scheme was in operation for the summer months only, but during the
past three years it operated from the 1st January to the 31st December.
All cases of notified enteritis are visited by the health visitors, and of the 78 notified during
the year 32 were classed as severe and 46 as mild. Forty-six cases occurred in infants under one
year of age, and 32 in infants aged one year and over. In only one instance was there more than
one case in the same family.
The council retain the part-time services of Dr. Ronald Carter, who has made a special study
of zymotic enteritis, for the treatment in their own homes of cases not attended by other doctors.
The following are extracts from a report by Dr. Carter on his work during the year :—
" I attended 58 cases in their own homes and paid 452 visits. I took three cases to hospital and
they all died ; these were the only deaths that occurred amongst the cases that I attended. One of
these cases was hopelessly ill when I was called in."
"Several doctors in the neighbourhood consulted me in regard to cases. One case that I saw in
consultation was that of a breast-fed child with blood and mucous in the stools. The doctor and parent
were seriously considering stopping breast feeding; the child completely recovered with treatment
without having its food changed."
"A considerable number of artificially fed infants under five months were being given an amount
of food which they could not digest, this was particularly the case when dried milk was given. These
cases require very careful readjustment of their diet."
"During the last year there has been a considerable increase in the number of cases dealt with under
the council's scheme. The doctors at the welfare centres have requested the nurses to attend those
suffering from early symptoms of dyspepsia with only slight diarrhoea and vomiting, but which were not
suffering from enteritis. The results have been excellent, and I strongly approve of this endeavour
of the council's medical officers to prevent enteritis developing."
"I have worked in close co-operation with the council's medical officers and when attending cases
I invariably forward them notes on the cases when I have ceased attending."