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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 is 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 59 deaths certified as due to diarrhoea, etc., and of these there were 50 children under
one year of age. Eight 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
five years it has operated from the 1st January to the 31st December.
All cases of notified enteritis are visited by the health visitors and of the 50 notified during the
year 21 were classed as severe and 29 as mild. Thirty cases occurred in infants under one year of
age, and 20 in infants aged one year and over. In four instances there were 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 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:—
During the year 1938, I attended 60 cases in their own homes and paid 430 visits. One case was
removed to hospital and died. This was the only death that occurred among the cases attended by me.
Doctors in the borough consulted me in regard to difficult cases. A health visitor requested me to
see an infant five weeks old who vomited breast milk for a week and had lost half a pound in weight.
It had a hard tumour at one end of the stomach, which is a sign of congenital pyloric stenosis, so I took
the case to the Infants' Hospital, Vincent Square, where they operated next day; the child is now
feeding well on the breast only. In this case the mother had been advised from an outside source to
stop breast feeding. A few cases of zymotic enteritis with high temperatures all did well at home on routine
treatment. The return to normal feeding had to be very gradual in some cases. Too rapid weaning
when the mother had to go to work caused several cases of diarrhoea and vomiting. Overfeeding on dried
milk was another cause. Ordinary liquid cows' milk was the food most frequently associated with
diarrhœa. The majority of the cases of diarrhœa and vomiting were due to catarrhal and dietetic causes.
Cases of " habit vomiting " were cured by giving belladonna before each feed.
In addition to the services of Dr. Carter, the council have an arrangement with the district
nursing association for the services of nurses to be available for the home treatment of diarrhœa.
During the year the nurses attended 127 cases, the total number of visits paid being 1,094. Twenty
of the cases did not respond to home nursing, and these were admitted to hospital, where three died.
Poliomyelitis and Polio-encephalitis.—Six cases of this disease were notified during the year,
three of the patients being females aged 21, 17 and 5¼ years and three males aged 25, 8 and 5¾ years.
In two cases the patient died; two cases are still receiving treatment, and two recovered after
treatment.
Measles.—This disease was made notifiable on the 1st October, 1938, but the following provision
is laid down in the Regulations—only the first case occurring in a family within two months shall
be notified.
Between 1st October and 31st December, five measles cases were notified.
During the year the women health officers paid 762 visits to measles patients. The number of
cases admitted to the London county council hospitals was 407. There were 12 deaths.
Whooping cough.—Whooping cough became notifiable for the first time on 1st October, 1938.
Only the first case occurring in a family within a period of two months is notifiable.
Up to the end of the year 118 cases were notified, and there were 5 deaths. Seventy-two cases
were admitted to London county council hospitals.
In the last quarter of the year a slight epidemic occurred in the borough, which tended to
increase towards December.
Whooping Cough Clinic.
In order to assist Kensington practitioners in the early diagnosis of whooping cough, and to
protect those children who have been exposed to infection, the council, in March, 1938, agreed to
the establishment of a whooping cough clinic with facilities for bacteriological diagnosis and prophylactic
inoculation of contacts.
The clinic was established at the Princess Louise hospital, and since 25th April, 1938, sessions
have been held on Mondays at 12 noon and on Thursdays at 2 p.m.
Dr. R. H. Dobbs, honorary assistant physician to Princess Louise hospital, is in charge. Mrs.
Gerald Jacobson undertook the preliminary organisation of the social work, and Miss Hazel Kahn
was appointed honorary social worker.
During 1938, 188 patients were seen by the physician in charge. These came from the following
sources:—
Public health department 151
Private practitioners 11
Family contacts 12
Other sources 14
Total 188