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(4) That the expectation of life after the onset of cancer of the breast
where the disease runs its own course may be taken as being on an average
not more than three years and six months.
(5) That in the aggregate, i.e., without reference to the stage of the disease
at operation, the effect of "complete" operation is to prolong life, increasing
the expectati'on of life from the onset of the disease by two to three years.
(6) That in patients operated upon by the "complete" operation while
the disease is still local, the expectation of life from the onset of the disease
may be on the average as much as ten years more than in un-operated persons.
At the request of the Statistical Sub-Committee of a Departmental Committee
appointed by the Ministry particulars were obtained, by the kind help and cooperation
of medical officers of health of the metropolitan boroughs, of deaths
from cancer of the breast in 1923, especially in regard to the interval elapsing, from
the time when the growth was first noticed to seeking medical opinion, and thereafter
to operation and death. The returns were analysed, and transmitted to the Ministry.
They form a useful supplement to the information collected by Dr. Lane-Claypon
from surgical records, but they are necessarily imperfect, since no cases of successful
operation, nor cases in which, subsequently to the operation, death occurred from
some other cause, are included among them.
Anthrax.
During 1924, six cases of human anthrax occurred in London, one of which
proved fatal. In 4 cases the patients were employed in handling imported hides.
Another example of indirect infection of anthrax, referred to in the Annual Report
for 1923, was furnished in the case of a school girl, aged 10 years, whose father
and brothers were engaged in handling bales of skins and hides at a riverside wharf
in Battersea. The child was treated in one of the general hospitals and recovered.
In the absence of any other ascertainable source of infection it was presumed that
infection was conveyed by either her father or one of her brothers, none of whom
were themselves affected. The sixth case which ended fatally was that of a man,
aged 61 years, who was residing at one of the Council's lodging houses. The source
of infection was deemed to have been a shaving brush, although bacteriological
examination of the brush proved negative. The patient bought the brush on 29th
July and cut his cheek whilst shaving the following day. He obtained medical
treatment two days later when he was suffering from an acute septic sore arising
from the cut and other constitutional symptoms. The man's condition was subsequently
diagnosed as anthrax and he died a day or two later. It was ascertained
that the brush used was of a foreign type, having a plain black wooden handle
without number or letters and it was understood that it had been purchased by the
retailer with others as surplus Canadian Red Cross stores, which were traced and
dealt with. All precautions were taken at the lodging house and there were no
developments.
Plague and
Cholera.
No cases of plague or cholera occurred in London during the year. The Council
renewed an agreement with the keeper of one of its lodging houses for the use of
the premises as a quarantine shelter for contacts of cases of plague, cholera, or other
dangerous infectious diseases should occasion arise.
Typhus fever
Cerebrospinal
fever.
No cases of typhus fever occurred in London during 1924.
Of the 97 cases notified, 27 were not regarded as genuine cases; on the other
hand 17 cases were recorded (mainly through the Registrar-General's death returns)
which were not notified under the Public Health (London) Act, 1891. The actual
number of cases was therefore 87, of which 69 (79 per cent.) proved fatal, as compared
with a mortalitv of 76.8 ner cent, the previous vear.
Poliomyelitis,
and polioencephalitis.
In 4 of the 116 cases of poliomyelitis notified the diagnosis was revised, and
there were 14 deaths. Reference is made in the school medical officer's report
pp. 43 and 44) to the facilities which have recently been provided for the
treatment of children suffering from this disease in the second stage of the illness
or after discharge from hospital following correctional operations. It has been