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Previous to the introduction of the antitoxin method of treatment,
the rate was 22 per cent,, but it cannot be too strongly impressed upon
medical men and parents that to be of use it must be used very early
in the disease.
In three instances three cases occurred in one house, and in four
instances two cases. Seven cases occurred in members of the nursing
staff of one of the general hospitals.
Typhoid Fever.—As usual, many of these cases resulted from infection
contracted out of London, often abroad, and these were generally visitors
in hotels. To shellfish of various kinds was attributed the source of
infection in a number of instances. Enquiry in one instance revealed
that the patient, a man, had visited Portsmouth on Easter Monday and
eaten 1½ dozen "butterfish" in an uncooked condition from a street
barrow. He was seized with illness shortly after, and eventually developed
typhoid fever. Dr. A. Mearns Eraser, Medical Officer of Health for
Portsmouth, informed me that notices warning the public against eating
these fish and cockles picked up off the mud have been displayed in
the town for some time, as a number of cases of typhoid fever have
been traced at different times to the consumption of butterfish.
Dr. Eraser was good enough to forward some of these fish, which are,
in external appearance, like large cockles. Examination by
Dr. J. Eoster Beale proved them to be polluted by sewage; 1,000
bacilli coli and 10 bacilli enteritidis sporogenes were found in each fish.
f rom one house two notifications were received relative to a brother
and sister. It was found that their mother had died a short time
previously, and there is a strong suspicion that she must have suffered
from this disease, although the symptoms were masked by chronic
alcoholism.
Continued Fever.—Two cases were notified; both were in puerperal
women, and should be included in the next group.
Puerperal Fever.—Three notifications were received, and three deaths
occurred (one of a person not notified). The two cases sent in as
" continued fever " and one of the puerperal were due to the death of the
child before birth from syphilis. Disinfection was carried out after
each case, including the clothing, &c., of those in attendance.
Cerebro-Spinal Meningitis or Spotted Fever.—The County Council on
the 26th February, 1907, made an order requiring the notification of
cerebro-spinal fever in the County of London for a period of six
months, which was later extended for a. further period of eighteen
months, as from and including the 13th September, 1907.
Meningitis, both in adults and children, may be connected with a
variety of conditions; therefore the County Council had to consider
what the term " cerebro-spinal fever " should include. On the advice