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did not spread. Puerperal Fever, one notification of this illness was received,
the immediate cause was not ascertainable, but the accumulation
of soiled linen was the agency by means of which the disease was supposed
to be conveyed to the lying-in person.
Erysipelas was certified in eighteen cases. Seven of these were
reported from the Colney Hatch Lunatic Asylum upon enquiry and
investigation this illness was not produced by insanitary condition nor
spread by personal contact or infection, the cases were more prevalent
during December, January, February and March, and no doubt the impaired
nutrition of the inmates of the Lunatic Asylum made them
susceptible to this illness, this disease was not confined to any particular
portion of the building.
Measles—In consequence of the number of cases of Measles in the
South Ward the schools were closed, and acting on my suggestion your
Authority added Measles to the list of notifiable diseases.
The cause of outbreak of Measles was the return to school of a child
not sufficiently recovered, in order to prevent such recurrence I urged
the importance of gaining knowledge of the first cases of Measles in order
to prevent spread and the only reliable way was to place this disease
on the list of notifiable diseases, I am aware the time is short to say
whether or no there has been any advantage gained, but already two cases
have been notified and these have been isolated, so that the illness has
not spread.
Diphtheria—this illness gave rise to considerable anxiety on account
of the number of cases notified. Four cases occurred in the earlier part
of the year in one house, a recently-built house, the cause was attributed
to the miasma from a hole partly filled with decaying vegetable matter
and forming a collecting chamber for the rain-water of the land around,
the children played on the sides and frequently stirred the stagnant
water, in two other cases notified the cause was attributed to the filthy
condition of back yard adjoining house, the yard was covered with black
mud and excreta from fowls. In four cases of Diphtheria, the supposed
cause was milk supply. In the early part of November there appeared
in the District several cases of sore throat illness with here and there
some well-defined cases of Diphtheria; I investigated this illness and wrote
several reports, the sickness was not confined to your District but was
also prevalent in an adjoining district. Between November 13 and 20
about 16 houses in all were affected with either Diphtheria or Sorethroats,
which the medical men in attendance attributed to a particular
milk supply, after careful investigation I ascertained that in all these
houses, the water, milk, and drainage were common; also that the
water and drainage were common to all the other houses in the neighbourhood
which had no illness. The number of houses supplied with milk by
one dairy was ascertained to be about 25 per cent. of the houses in the
District and of these about 17 per cent. were affected with sore throats or
Diphtheria. Bacteriological examination of the exudation on the throat in
many cases did not show the presence of the Lœffler's Bacillus. On