London's Pulse: Medical Officer of Health reports 1848-1972

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St Pancras 1904

[Report of the Medical Officer of Health for St. Pancras, London, Borough of]

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It is well to know that unrecognised cases largely spread infectious diseases.
Discovery. —Mild cases of indisposition or disease excite no particular attention
or are attributed to other than the real cause by parents, guardians, or friends,
and are not submitted to medical examination. This is particularly the case
with chicken-pox, and when small-pox has been prevalent this has occurred on
many occasions with disastrous results. In order to discover promptly the
localities of cases of chicken-pox, and the ages, etc., of the patients, notification
of the disease is required, and the practical effect of this is also to cause
medical opinion to be sought. The London County Council during the
prevalence of small-pox made the notification of chicken-pox compulsory for a
period of four months dating from the 30th of March. When cases of
suspected infectious diseases are discovered there is sometimes considerable
difficulty and delay in making an exact medical diagnosis in certain types of
the diseases. Here bacteriological and additional clinical examination are
brought to bear upon doubtful types, and to check or confirm the diagnosis.

Bacteriological Tests.—The number of specimens of secretion, blood and sputum submitted to bacteriological tests during the year in suspected cases of Diphtheria, Typhoid or Enteric Fever, and Tuberculosis, and the results of examination were as follows:—

Bacillus found.Doubtful.Bacillus not found.Total.
Diphtheria (Secretion)2526592
Reaction obtained.Doubtful.Reaction not obtained.Total.
Typhoid (Blood)26..4672
Bacillus found.Doubtful.Bacillus not found.Total.
Tuberculosis (Sputum)3..69

Clinical Examination.—In the case of Small-pox, to which disease no
bacteriological test is at present applicable, the London County Council provided
for additional Clinical Examination by arrangement with two experts, formerly
officers at the Small-Pox Hospitals, so that their services were made available
by telephone, telegram, or letter, from the 30th March to the 7th August.