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45
me of any suspicious case, so that I might see the patient with them. As
a result of this I was enabled to see many cases suspected to he smallpox.
Subsequently (27th February) the Council temporarily appointed
Dr. P. J. Wilkinson to act as "consultant in doubtful cases of smallpox
where the Medical Officer of Health is unable to attend personally,"
and the County Council also appointed him one of their consultants for
a like purpose. Dr. Wilkinson had previously been appointed one of
the Deputy Public Vaccinators for the Strand Union, and the combination
of offices proved of great value, and enabled the offer of vaccinato
be made to persons in contact with a case within a few moments of
its discovery. Of the 302 actual cases notified, 220 were seen by
Dr. Wilkinson and myself, and in addition, 43 persons were seen who
were not suffering from small-pox: these were:—18 cases of chickenpox,
14 some form of skin disease, 4 influenza, 3 measles, 2 pneumonia,
1 German measles, and 1 vaccinia. These cases were consequently retained
at home.
Notification of Ohiclcen-pox.—On the 27th December, 1901, the
Local Government Board suggested that as many cases of small-pox
have been regarded merely as cases of chicken-pox, this latter should be
made notifiable. This the Council agreed to do, and their action received
the approval of the Board and came into force on the 24th January.
Subsequently the County Council resolved to make such notification
general for all London, and extended the period to the 6th January, 1903.
During that period 25,698 cases have been notified in London, at an
approximate cost of £3,000; of these, 746 cases (499 private, 271 public
certificates) were notified in Westminster, at a cost of £75 18s. 6d. In
my tenth Monthly Report I wrote that, "From the intimate relations
which have been established between the medical practitioners and
your Medical Officer, by which his services were at their disposal, so far
as practicable, doubtful cases were at once brought to his notice, hence
notification of chicken-pox has been of little use in Westminster.
However, it appears from the report of the London County Council that
in one or two boroughs it proved of great value."
Removal of Cases to Hospital.—The Metropolitan Asylums Board
deserve great credit for the prompt manner in which cases were removed
at all hours of the day and night. In Westminster only five cases*
were isolated at home, the remainder, except three-—who died before
recognition of the nature of the disease, or removal could be effected—
were treated in hospital.
*Three of these were sent to hospital but returned as not small-pox, and were
subsequently isolated at home. (See above.)