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14
Malaria was notified on four occasions. None of the patients
derived their infection in this country.
Cerebrospinal Meningitis was notified on two occasions, and
two cases of Encephalitis were notified during the year.
Enteric Fever was notified on one occasion only. The source
of the infection was not ascertained.
Pneumonia.—Pneumonia has been termed "the captain of
the men of death," and seventy-four deaths in Hornsey were
caused by it last year. In addition 78 deaths were caused by
bronchitis.
It is impossible in considering the epidemiology of pheumonia
to dissociate it from other and similarly infective conditions
such as the common cold and bronchitis and influenza.
All these diseases are spread from person to person by
the breath, and all are associated with the presence of small
microbes called "micrococci" of one sort or another in the
respiratory passages. Both pneumonia and bronchitis, and to
a less extent the common cold, are crippling diseases which tend
to leave the sufferer, after recovery, in a state of sub-health.
Especially is this the case with children, to whom an attack of
one of these infections may be of life-long detriment. It is after
an attack of bronchitis or pneumonia that a prolonged holiday
in a convalescent home or in an open-air school is of such importance
in achieving a real and complete cure.
The prevention of these diseases, and indeed of all those
spread by means of the respiratory tract, is a matter of the
greatest difficulty. With our present knowledge the most promising
hope of success appears to be by the use of "prophylactic
vaccines." The prevention of bronchitis and pneumonia
by means of vaccines has been brilliantly successful among the
natives in South African mines; and, in the opinion of many
competent to judge, it has been of value also in this country.
During 1922 a mixed vaccine designed to protect against
attacks of "cold," bronchitis and pneumonia was distributed in
Hornsey, free of cost, to CO doctors. In September, 1923, I
wrote to all these doctors asking how they liked this vaccine
and enquiring of what value they had found it in their practices.