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once instituted at the child's home in Fulham with a view to ascertaining the source
of infection, as the date of the commencement of her illness indicated that she was
infected about the end of the Summer holidays. The Medical Officer of Health of
Fulham ascertained that the child had eaten mussels a day or two before she returned
to school. The mussels had been collected at a sea-coast town in Devonshire by
a friend of the family and conveyed to London. Five persons partook of the
mussels, and, of these, the girl alone was attacked with illness. There was no
suggestion that conditions at the school were responsible for her illness and it was
assumed that the mussels were the source of infection.
PentonviUe Place of Detention was invaded by diphtheria on two separate occasions,
but the precautions taken prevented the disease from spreading. Two cases
of the disease were reported on 30th June, and as a result of the bacteriological
examination of the remainder of the children, 4 were found to be harbouring
diphtheria bacilli, and were at once removed to hospital. On the second occasion
a boy was found by the medical officer to have a sore throat and was isolated. A
swab from his throat yielded diphtheria bacilli and he was removed to hospital.
Following his removal, 21 other boys were swabbed and two found to be diphtheria
carriers, although neither had any clinical symptoms. They were removed to
hospital as a precautionary measure. Another case occurred on 20th October,
and bacteriological examinations of the remainder revealed the presence of another
carrier who was forthwith removed. An investigation of the sanitary condition
of the place of detention revealed certain defects in the drains and fitments which
were at once promptly remedied.
As a result of these outbreaks, the Education (Special Services Sub-) Committee
gave instructions that in future all new admissions to the two places of detention
(Ponton-road and Pentonville) should be bacteriologically examined before being
allowed to mix with the others. This has since been consistently carried out.
Between October 23rd, 1925, and March 8th, 1926, 258 new admissions to Pentonville
Place of Detention were bacteriologically examined, of which two were found
to be carrying germs of diphtheria. At Ponton-road Place of Detention 83 new
admissions were similarly examined in the same period, but all with negative result.
Encephalitis Lethargica.
Encephalitis has caused widespread anxiety on account of the apparently sudden
appearance of a new disorder, characterised not only by a high death-rate in the
initial attack, but also showing in many cases relapses and sequelae of a grave and
pathetic nature. In some patients the original disease seemed never to clear up,
whilst, in others, after an interval of apparent health, there were relapses into
conditions resembling the shaking palsy of old age, or to partial paralysis and states
of muscular twitchings and tremor, or character changes and considerable mental
disorder. The after-effects seemed to be more marked in the younger sufferers
who, if they survived the initial attack, but did not completely recover, seemed
doomed, as has been described in popular language, to a condition either of premature
senility or of "possession by a devil." The disorder is perhaps not quite so new
as was at first thought, nor the outlook quite so hopeless. While from the administrative
side it must be realised that " epidemic encephalitis " is only one of a series
of diseases affecting the nervous system in a somewhat similar manner, it certainly
produces the most spectacular after-effects. The name " encephalitis," however,
demands a moment's consideration. Encephalitis means inflammation of the brain,
the first part of the word coming from the Greek encephalos, meaning brain, while
itis is from the Greek word meaning inflammation. This is mentioned because
kindred diseases, affecting other parts of the nervous system, have names constructed
in a similar manner—e.g., myelitis, from the Greek word myelos, meaning
marrow, the name give to the spinal cord, a root which is used in the word