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192 0
at a general hospital, or at the School Clinic. An inquiry was made
of the condition of these cases at the end of 1920, and the result
was as follows:—
Cured.
Better.
No
improvement
Ear discharge 8 2 2
Inflammation of Eyelids 8 2 1
Deafness — — 1
Nasal Discharge 1 — —
Scarlet Fever.
There was a considerable increase in the number of notifications
of scarlet fever, but no deaths occurred from the disease.
The ages and the Ward distribution are given on Table 9.
In the autumn a wave of excessive prevalence passed over
London and the extra-metropolitan districts, and it seems that
a record number of cases were under treatment in the hopsitals
of the Metropolitan Asylums Board. We did not experience the
same strain upon our accommodation as they did in London,
and at no time was the hospital full. The disease was in many
respects similar in type to that observed in interepidemic years.
Usually when an epidemic occurs the type of the disease is also
of a more severe character. But last year the type was a very
mild one, and from the experience gained of the patients admitted
into the hospital, there is no doubt of the frequent occurrence of
mild or abortive cases which escaped diagnosis.
In many instances the early symptoms were so evanescent
and subsequent desquamation so indistinct that it was almost
impossible to say definitely whether the process had taken place
or not.
Many cases came under my observation where the parents
were positive that a rash had not appeared ; at any rate, the rash
had not been observed. The following case may be taken as
typical. W;B. was seen on December 2nd prior to his return to
school as a contact. His twin sister had been removed to hospital
on November 23rd. The boy had had a sore throat on or about
November 21st, and was also sick at the same time. He was seen
by a doctor, and the parents were positive that there had been no
rash. On December 3rd his tongue had the appearance of the tongue
of Scarlet Fever patients in the second week—slightly red with
the papillae showing—the submaxillary glands were enlarged, and
the orifice of the nose was inflamed and slightly excoriated. Personally
I have no doubt that he had a mild attack of scarlet fever,
though the subsequent peeling was very indistinct.