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

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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During the year under review serum was collected at intervals from patients
convalescent from acute poliomyelitis at the Wingfield-Morris Orthopaedic hospital,
Oxford, and at the Royal National Orthopaedic hospital, London, from which supplies
were also obtained in the two previous years. In addition, Drs. L. P. Garrod and G.
Murray Levick made considerable additions to the serum pool with blood taken from
patients at St. Bartholomew's hospital, London, and the Heritage hospital for
cripples, Chailey, respectively.
The arrangement whereby the main supply of serum was deposited at the Western
hospital, with subsidiary stocks at certain of the London voluntary hospitals, was
found to work satisfactorily in practice, as serum is readily available to practitioners
at any hour of the day or night. During 1934, there were 29 applications for serum
in amounts varying from 25 c.c. to 200 c.c., making a total issue of 2,500 c.c. for the
year. In 14 instances the full dose issued was administered chiefly by the combined
intravenous and intrathecal routes; on 4 occasions only one-half the requisitioned
dose was given, while 11 cartons were returned unopened, either because the diagnosis
was revised in the interval, or more commonly, because the disease was recognised
at a stage when but little benefit was likely to follow administration of the serum.
It must be admitted that, as long as acute poliomyelitis remains a sporadic
and relatively infrequent disease, serious practical obstacles will attend attempts
at its control by means of immune serum, with corresponding difficulty in assessing
the therapeutic efficacy of the serum. Only by timely administration of the serum
to a considerable number of suitable cases, and by collation and analysis of detailed
and accurate records of the clinical results following its use, will it be possible to
arrive at a trustworthv estimate of its worth.

The following statement shows the numbers of notifications in recent years o the diseases specified, excluding duplicate notifications and military cases:—

Cerebro-spinal fever939383937012188175247216137
Encephalitis lethargica600293224142100926040472229
Poliomyelitis and polioencephalitis11655958654663756896674

The following table shows the age incidence of actual cases of smallpox and the three kindred diseases, cerebro-spinal fever, poliomyelitis (including polioencephalitis) and encephalitis lethargica.

Age periods.Under 3.3-5.5-10.10-20.20-30.30-40.40-50.50-60.Over 60.Total.
Poliomyelitis and polioencephalitis151716142165
Cerebro-spinal fever4711821238321124
Encephalitis lethargica2165531124

In 1934 (52 weeks) particulars of 332 cases of food poisoning notified to the
borough medical officers of health under the provisions of the London County Council
(General Powers) Act, 1932, were received, compared with 419 for the year 1933.
Three of the notified cases died.
In some instances more than one member of a family was affected by illness,
but the majority were isolated cases and were probably due to idiosyncrasies of the
patients. Particulars are set out below of the only groups of cases that call for special
On 6th February, 22 inmates of the Bromley House institution developed symptoms
of gastro-enteritis and 6 of the patients were removed to hospital where they
remained for periods varying between 2 and 7 days. There were approximately 530
nmates in the institution at the time, and 14 members of the staff had meals in the
building. An investigation was carried out by the medical officer of health of Poplar