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35 U934
The section of the Public Health Act referred to is that which enables the
authority,with the sanction of the Local Government Board,to provide a temporary
supply of medicine, etc., for the poorer inhabitants of their district. (See also
page 40.)
Applications in respect of 8 children were received for Diphtheria immunisation
(Schick Test) during the year. Cost, £4 0s. Od.
ANTI-TOXIN TREATMENT.
During the year 34,000 units of Diphtheria Anti-toxin serum were issued to
Medical Practitioners in the Borough. Of this quantity 30,000 units were sold,
the total amount received by the Council being £1 9s. 9d. The remaining 4,000
units were given free, owing to the patients' limited means.
Scarlet Fever.—1,089 cases were notified, and they showed a decrease of
30 on the average (1,125) of the ten years 1924-33. The attack-rate was equal to
3.47 per 1,000 of the civil population annually, which is an increase of 0.04 per
1,000 of the mean rate (3.43) of the preceding ten years. In London the attackrate
was 4.3 per 1,000 of the civil population.
As will be seen by the Table, page 00, 79 cases of Scarlet Fever were treated
at home. A proportion of these of course were due to the London County Council
circular stating that the accommodation for Scarlet Fever was limited in view of
the increased treatment of Measles. Cases of Scarlet Fever were only admitted to
Hospital on the recommendation of the Medical Officer of Health from 11th January
until 9th July inclusive.
Enteric Fever.—A total of 6 cases of Enteric Fever were notified. This
is a decrease of 12 on the average (18) that obtained during the ten years 1924-33.
The attack-rate was 0.02 per 1,000 annually, a decrease of 0.03 on the mean rate,
0.05, of the last ten years. In London the rate was 0.03.
A detailed investigation was made in regard to a case of Enteric Fever occurring
in an institution. This occurrence in itself would not have been thought out
of the ordinal) except for the fact that in occasional years in this same institution
an odd case of Enteric Fever had occurred, and the Superintendent of the Institution
approached me to see if I could explain why, when a case of Enteric Fever did
occur in the institution, it so happened that it was always the inmate of a particular
room. A careful examination of the room itself, even to the extent of lifting a
portion of the flooring revealed nothing ; the water supply and the cistern likewise.
Attention was then directed to the outside of the building to ascertain the possibility
of anything having entered by the window of the particular room. A small
distance to the side of the particular window was the entrance to the stoke-hole of
the heating apparatus of the institution. It was noticed that one of the flagstones
was damp. This w as removed, and underneath was found a drain which had been
broken into, evidently to provide a surface water drain for any water which may
accumulate in the stoke-hole. This w as followed up, and it was found to enter a
three-way junction channel. The manhole cover at the spot where the three-way
junction existed was removed, and a careful examination showed that the channel
had sunk since its construction and had approximately 2 inches of an adverse fall,
that is, the channel sloped in the wrong direction. There appeared sufficient
evidence that foul gases could go back along the drain to the stoke-hole flag floor,
and in certain conditions might be wafted towards the window ; there was also the
question of the carriage of infection by flies and other means. The reason there