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deaths from 'diarrhœa' —the 'epidemic diarrhœa' of the Nomenclature of Diseases—the Incorporated
Society of Medical Officers of Health is desirous of calling the attention of all medical practitioners to
a decision which has been arrived at by that College authorizing the use of the term 'epidemic
enteritis' (or, if preferred by the practitioner, 'zymotic enteritis') as a synonym for epidemic diarrhœa
(Nomenclature of Diseases, p. 9, ed. 1896); and urging the entire disuse, as synonyms of epidemic
diarrhœa in medical certificates of death, of such terms as 'gastro-enteritis,' 'muco-enteritis,'
'gastric catarrh,' etc.
"The confusion arising from the present practice in certification so seriously vitiates the
accuracy of all statistics with regard to this disease, which is recognised by the Royal College of
Physicians to be a general disease of specific character in the same sense as enteric and other fevers,
that this Society desires to strongly urge medical men to strictly adhere to these authoritative decisions
which the College has now published.
"In future the only authorized names to be used in certifying deaths from this disease are:
epidemic enteritis, zymotic enteritis, or epidemic diarrhœa, and all other synonyms are to be entirely
discarded.
"The late Dr. Ballard showed that this specific disease occurs in persons of all ages, and that it
may happen in other than epidemic seasons, under which circumstances the Society would suggest the
advisability of the employment of the alternative term, zymotic enteritis."
CHICKEN-POX.
On the 9th October, 1901, the Council unanimously agreed to the notification of chicken-pox,
which came into force a week after the advertisement, on the 12th October. From this date 48 cases
were notified, 20 in Bloomsbury and St. Giles, and 28 in the Holborn Sub-district. One of the
first cases notified, I found on examination to be a case of Small-pox. Another case of Small-pox was
notified in December as chicken-pox. One case that was not notified at all, I discovered to be
suffering from small-pox, on account of a case of small-pox afterwards occurring in the same family.
A relative living in the same house also contracted small-pox from the boy who was thought to be
suffering from chicken-pox.
A girl 4 years of age who was notified as suffering from Small-pox, I found on examination
to have chicken-pox, and was not removed to hospital. Medical practitioners asked me to see many
doubtful cases of small-pox or chicken-pox before they notified them.
I prepared the following:—
Report on the Notification of Chicken-pox.
I suggested to the Chairman of the Public Health Committee (Professor W. R. Smith, M.D.,
etc.) that chicken-pox should be made a notifiable disease. I am glad that he at once gave notice of
motion that such should be the case for a period of six months from the 9th October.
Many outbreaks of Small-pox have been caused by a case of that disease not being diagnosed
or recognised as such. The disease for which small-pox is most often mistaken is chicken-pox, and
vice versa.
On account of the great difficulties of diagnosis in many cases, the Metropolitan Asylums
Board, "on the 17th July, 1893, opened the shelters at the South Wharf for the detention, until such
"time as the accuracy of the original diagnosis could either be confirmed or disproved, of cases as to
"which the Board's Medical Officer on the spot was in doubt."
In the seven following years, 1894-1900, inclusive of 2,852 cases examined at the Wharf,
479 cases or 16.8 per cent. were considered not to be Small-pox, and of these 479 in more than 260,
that is more than 54 per cent., the Board's expert was in doubt and they were detained at the Shelters
until a diagnosis could be made. Also more than 100 of the cases of Small-pox were so detained at
the Shelters before being sent to the Hospital Ships.