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definite occurrence of cerebro-spinal fever in a locality, or by reason of the
prevalence in a particular neighbourhood of illness not clearly referable to
definable cause. In these circumstances, there would be advantage in the local
medical officer of health endeavouring to secure, by arrangement with the
medical men practising in his district, information as to the existence of cases
of the kind in question.
Failure to recognise cerebro-spinal fever is also apt to happen when the
malady is of the "fulminant" variety, in which death ensues rapidly. In
these instances the disease has been mistaken for typhus fever, idiopathic
tetanus, or malignant measles.
An important aid to diagnosis may be found in examination of cerebrospinal
fluid, withdrawn from the lower part of the spinal canal by lumbar
puncture, for the presence of the "diplococcus meningitidis intracellularis"
of Weichselbaum; a micro-organism which is now generally regarded as
the specific cause of cerebro-spinal fever.
DIPHTHERIA AND SCHOOL ATTENDANCE.
In April, 1906, the Metropolitan Branch of the Incorporated Society of
Medical Officers of Health, considered the mode of the spread of Diphtheria in
Schools, and decided, "that it is desirable that in the event of the prevalence
of diphtheria in any district, any Child excluded from school for sore-throat
should not be admitted to school without a certificate of freedom from infection,
based on bacteriological examination."

The number of cases of Notifiable Infectious Diseases removed to hospital in
each week of the vear were as stated in the attached table.