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who has had an attack of the disease before allowing him to return
to school.
One slight outbreak of 4 cases occurred in an isolated part of
the District, due to infection by a visitor, a small boy with a sore
nose, who came down to the country to recuperate after a prolonged
residence in an isolation hospital, where he had been suffering from
Diphtheria.
In his Annual Report of the Enfield and Edmonton Joint Hospital
for 1912-13, the Physician Superintendent, Dr. Haldane Cook,
writes very fully on the subject of the use of anti-toxin, and I very
strongly recommend a perusal of this report to every member of
the medical profession practising in the District.
Dr. Cook complains of the few cases, 34 out of 171, which had
had a dose of anti-toxin before admission to the Hospital, and
strongly urges that the duty of the doctor is to administer this
remedy at the earliest possible moment.
ENTERIC FEVER.
Two cases of this disease were notified during the year, but a
careful investigation failed to shew the source of infection in either
case. The sanitary condition of both houses was quite satisfactory.
POLIOMYELITIS.
Poliomyelitis was a newcomer on our list of notifiable diseases
on the 1st April, 1912, and the first case was notified to me on
July 29th, 1913.
The total number of cases during the year was 9, with no
deaths.
In accordance with a request from the Local Government
Board, I prepared a special report on these cases, a copy of which
is appended
September 3rd, 1913.—"Seven cases of this disease were
"notified in Enfield between July 28th and August 29th, the par"
ticulars of which are set out below :—
"A.B.—This child went to Bucks., on a visit to a Mrs. W .
"near Aylesbury, on July 14th, and was taken ill whilst there.
"A medical man saw her and thought she was suffering from
"'General Malaise.' She returned home on July 25th, was seen
"by Dr. S. next day, who found her suffering from Paralysis.
"On the same day I saw the case with Dr. S. and agreed with him
"that it was undoubtedly a case of Poliomyelitis."