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44
of a committee appointed by the President of the Royal College of
Physicians, they have decided that, for notification purposes, the disease
at present known as posterior basal meningitis is included in the term
"cerebro-spinal fever." That term, however, is not to be interpreted to
include cases of meningitis due to tuberculosis, syphilis, middle-ear
disease, or injury.
One hundred and thirty-two cases were registered in London, four
being in Westminster. Enquiries were made with regard to all deaths
from meningitis where not due to one of the above-mentioned causes.
Some of them might be included as cerebro-spinal fever, but in a
number the cause could not be determined m the absence of a postmortem
and bacteriological examination, probably the pneumococcus
which produces pneumonia was responsible for a proportion, and
influenza for others.
There has been no epidemic of this disease, as has occurred in other
towns, as Glasgow, Leith, Belfast, Hamburg and in America. It is
believed that these towns have been specially affected through being
sea ports, many passengers from Eussia, Germany, &c., passing through
them on their way to America. Dock labourers in Leith were found to
have organism in their throats, and the same germ was found in the
engine room and hold of a ship. Dry and dusty weather appears to
favour its spread, and the germ may be either inhaled or consumed in
food to which it has gained access in the dust. It has also been
suggested that as in the case of tuberculosis so in this disease, children
are more liable to be attacked because they play about on floors which
may be infected by the promiscuous spitting of an infection-carrying
" intermediary " such as the lather. In trying to control this disease,
steps must be taken to detect the "intermediaries," to destroy the
organism which they may be carrying about, and disinfect the places
frequented by these people.