View report page

14
Lambeth bought the brushes shortly after the War, and, when his business in Stepney was given
up in 1930, the brushes which had been overlooked at the back of a drawer were sold with the
rest ot the stock. The original owner stated that he had intended to destroy them, but forgot
to do so. The country of origin had also been forgotten, but from various indications there
seemed little reason to doubt that they were of continental origin.
There also arises the difficulty that the man shaved with the brush at least once after the
pustule was noticed, and it is possible that the brush may have been infected from the pustule
and may, therefore, not be the primary cause.
The man was a small cobbler in his own employ, and had purchased some leather on 2nd July.
As the leather was tanned and dressed ready for soling it did not appear a likely source of infection,
but samples, nevertheless, were taken for examination with the expected negative result. He
almost invariably shaved himself and the last time he had been shaved by a barber was at least
a fortnight before the onset of his illness, and after inquiry no suspicion was attached to the
barber's utensils.
The man's shaving brush would seem to have been the obvious source of the disease, but
its prolonged use without giving rise to infection is amazing.
The patient in Deptford, a woman aged 48 years, was taken ill on 24th November
and was admitted to St. Alfege's hospital on 29th November. The medical officer
of health of the borough of Deptford gave the following account of the case :—
Two days after admission to hospital the temperature subsided and oedema of face resolved,
leaving a black central scab surrounded by a ring of vesicles on an inflamed base about 2 inches in
diameter. The patient is now recovering, but the scab has not yet separated. It appears to be
a ease of infection with an anthracoid organism of low toxicity. " Direct smear negative; culture,
morphological anthrax bacilli isolated but not confirmed by biological test."
The medical superintendent of St. Alfege's hospital later reported that the
case was clinically considered by various consultants to be one of mild anthrax, but
the course of the disease was too prolonged and a positive Wassermann reaction was
obtained. An ultimate diagnosis of gumma of the cheek was made.
Smallpox.
No case of smallpox was notified during the year. London has now been free
from this disease since June, 1934. In March, one ship on which smallpox had occurred
during the voyage arrived in the Port of London from Brisbane. The patient had
been landed at Suez. The vessel called at Marseilles. The list of London addresses
given by passengers who landed in order to proceed overland to London was received
from the Ministry of Health and circulated to the medical officers of health of the
metropolitan boroughs. On arrival of the vessel in the Port of London all precautionary
measures were taken by the port medical officer, including the notification
to the medical officers of health concerned of the names and addresses of passengers
and crew. No secondary case was reported.
Information was also received from the Ministry of Health in March that a
vessel had arrived at Marseilles with a suspected case of smallpox on board. A
list of the names and addresses of passengers who landed at Marseilles and travelled
overland to London was circulated to the medical officers of health of the metropolitan
boroughs. Information was later received that the suspected case of smallpox
had been diagnosed as chickenpox.
Cerebrospinal
(spotted)
fever.
During the year 105 notifications ot cerebrospinal fever were received, but in 16
of these the diagnosis was not confirmed. Of the 89 actual cases, 50 proved fatal.
In addition, 19 deaths were recorded by the Registrar-General of cases which had
not been notified, making a total of 69 deaths.
Encephalitis
lethargiea.
The notifications ot encephalitis lethargica numbered 15. One case was not
confirmed. Of the 14 actual cases, 4 proved fatal. In addition 26 deaths were
recorded by the Registrar-General of cases which had not been notified, and 4 which
had been notified in previous years, making a total of 34 deaths for the year.
Particulars of cases admitted to the post-encephalitis lethargiea unit at the
Northern hospital are given in Vol. IV (Part I) of this report.
Poliomyelitis
and polioencephalitis.
Notifications of poliomyelitis and polioencephalitis numbered 85 ; the diagnosis
was not confirmed in 3 of these. Of the 82 actual cases, 5 proved fatal. In addition,
4 deaths were recorded by the Registrar-General of cases which had not been notified,
and 2 which were notified in previous years, making a total of 11 deaths during
the year. Particulars of acute cases admitted to the Western hospital and of cases
admitted when convalescent to Queen Mary's hospital for children, Carshalton, for
treatment of the crippling effects of the acute stage, are given in Vol. IV (Part I) of
this report.