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188
1911]
The Medical Officer of Health entirely concurs with these proposals, and
he is firmly convinced that the time has arrived when something more than
is now accomplished should be done to prevent the large amount of blindness
that occurs among newly-born infants, and he recommends—
(1) That midwives should receive special instructions as to the cause of
this disease and how to recognise it in its early stages; and
(2) That they should have power to call in medical advice to assist them
in the treatment of the disease.
NOTIFICATION OF POLIOENCEPHALITIS AND
POLIOMYELITIS.
Under section 56 of the Public Health (London) Act, 1891, the London
County Council is empowered to make an Order rendering it compulsory to
make notifiable an infectious disease not included in the above Act against
which it is desirable in the interests of the public health to take precautions.
This Order is practically an extension of that relating to Cerebro-Spinal
Meningitis, as these are allied diseases, and are prubably caused by the same
bacillus.
Since 1905, when an epidemic occurred in Sweden, it has been known in
Southern Europe and the United Slates of America, where it has appeared
with considerable intensity in different States since 1907. It usually suddenly
attacks persons in apparently good health, who, at first, may experience a
sharp rise of temperature, although some cases may run their course without
fever. According to Dr. H. A. Macewen, the range of temperature varies
from 99 to 102.2 degrees F., although in the New York epidemic in 1907 it was
somewhat higher, ranging from 101 degrees to 104 F. The fever seldom lasts
longer than from two to seven days, but the fever in itself is no criterion as to
the severity of the attack. There is usually great prostration, muscular
weakness and weariness, while in" a large proportion of the cases there is
headache. There may also be gastro-intestinal disturbances, and one observer
(Krause) found digestive disturbances present at the onset in 90 per cent, of
the cases in an epidemic which occurred in Germany. Nervous symptoms
and severe drowsiness is of frequent occurrence, while irritability and restlessness
are common; meningeal symptoms are of frequent occurrence, and
pain, stiffness and rigidity of the neck are met with, while in severe cases the