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11
SEPTIC DISEASES.
Gate, West, 10.31; Lancaster Gate, East, 25.64 ; and Hyde Park, zero. In these Wards zero rates
were recorded on 5, 6 and 4 occasions respectively during the preceding decennium. It is permissible
to hope that, notwithstanding the increase in the mean rate for the second quinquennium, a reduction
in the prevalence of this disease may be looked for in the near future.
Five (5) of last year's cases received institutional treatment, 4 in St. Margaret's Hospital (M.A.B.)
and one in the Central London. The District Nurses took charge of 4 of the cases treated at home.
One infant died (of premature birth) before the case was "cleared," but the remaining 14 other infants
suffered no damage to their eyes. The only case during the year with any damage (ultimately recovered
from) was the infant whose attack was reported by the Health Visitor.
SEPTIC DISEASES.
Erysipelas.—Last year 77 cases (males 25, females 52) were notified, the total for 1921 having
been 83. During 1909-13 the annual average was 90, and during 1914-18, 101. Last year's notified
cases were equivalent to a rate of 0.53 per 1,000 persons, the rate for males being 0.41 and that for
females 0.61. In 1921 the rate (persons) was 0.57.
The cases reported last year included at least one of erroneous diagnosis and 4 cases contracted
in hospital. One patient was reported with the disease twice during the year, and in 2 instances the
patients were known to the Department as having had the disease the one twice and the other 3 times
previously.
The seat of the disease was reported to be : Head, 44 cases; lower extremity, 20 ; upper, 6;
trunk, 3; and not stated, 4. Although it is believed that a "wound" is a sine qua non as the site
of infection, in 30 instances only was a history of "trauma" obtained.
Including the cases contracted in hospital, 23 received institutional treatment (29.8 per cent.
of the notified cases). Four of the 77 patients died after notification, one of the deaths being certified
as due to a cause other than erysipelas. Two of the 3 deaths occurred in institutions. The mortality
was 0.02 per 1,000 persons. During 1910-12 the mortality was at the rate of 0.03 per 1,000 males,
and during 1920.22, 0.04—increase 33 per cent. The mean rates for females for the same periods
were : 1910-12, 0.04; 1920.22, 0.02—a fall of 50 per cent.
Other Septic Diseases.—In addition to the three deaths from erysipelas, there were 15 from
other varieties of septic disease, making a total of 18 deaths from all forms of sepsis, other than puerperal
fever, during the year, equivalent to a mortality rate of 0.12 per 1,000 persons. During 1910.12,
the mean mortality rate was 0.10 per 1,000, the same rate prevailing during 1920-22. There was,
however, some increase in the mortality among males—1910-12, 0.11; 1920-22, 0.12—and a decrease
among females—1910-12, 0.09; 1920-22, 0.08.
OTHER NOTIFIABLE DISEASES.
Anthrax.—.One case was reported last year, the patient being a butcher's assistant working at
Edgware, where he received his infection, probably when destroying the carcase of a horse found dead
in a field. The interval between that act and the date of sickening precluded demonstration of the
infection in the horse. The patient was admitted to hospital, and made a good recovery.
Malaria.—Five (5) cases were reported during the year, 2 less than in 1921. All the patients
were adult males, and satisfactory evidence was obtained in every instance of the disease having been
contracted abroad.
"MENINGITIS" GROUP.
Cerebro Spinal Meningitis (or Fever).—Last year 2 cases were reported, the same number
as in 1921. One of the patients (male, 8 months) resided in Church Ward, the other (female, 49) in
Hyde Park. In both cases the diagnosis was verified by bacteriological examination, and both
patients were treated in hospital. The infant died, the death being certified as due to "meningococcal
posterior basic meningitis." The woman was known to have visited the country shortly before
sickening, but no evidence could be obtained of the disease having' been contracted there.
Encephalitis Lethargica.—In 1921,7 cases (including 2 errors) were reported, last year 2 only—
a male, 46, and a female, 15. One patient resided in Harrow Road Ward, the other in Church. The
woman's case was verified bacteriologically, and she was treated in hospital. The man's case was of
the "ambulant" type. He attended the out.patient department of a hospital. The diagnosis of
this case was more than doubtful.