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Scarlet Fever had arisen. By this test and a subsequent prophylactic dose of Scarlet Fever antitoxin
it is found that complete control over any further occurrence of cases can be maintained.
With regard to the prevention of Diphtheria by Schick testing and active immunisation against
the disease the Medical Superintendent records that since this method was brought into operation
at the Hospital there have been no cases of diphtheritic sore throat amongst the staff. Previous to
this year the incidence of Diphtheria amongst the nurses at the Hospital had been high.
MIXED INFECTIONS.
During the year 100 patients were admitted suffering from conditions other than Scarlet
Fever or Diphtheria. 62 cases admitted as Scarlet Fever or Diphtheria proved to be suffering from
Tonsillitis, while 10 cases of mixed infection occurred during the year.
This large variety of cases, namely, 172 out of a total of 846 admitted, indicates the great
necessity for isolation cubicles, which the Council propose now to erect.
SPECIAL REPORTS AND ARTICLES.
There are three reports appearing in the appendices written by members of the medical staff,
to which I desire to call the attention of the Council.
Artificial Light Treatment.—Dr. Haldin-Davis contributes the report on Artificial Light
Treatment—Appendix G. He lays stress on the value of this form of treatment in anaemic and
debilitated cases, including pre-tubercular cases, cases of enlarged glands, rickets, asthma and diseases
of the skin. He also instances certain cases in which the mentality of the child was improved as a
result of treatment.
Altogether 196 cases attended at the Artificial Light Centre during the year 5,341 times.
17 was the average attendance per session, and each child treated was treated on the average 33
times. There is always a considerable waiting list for treatment at this centre.
Rheumatism in Childhood.—Appendix H is written by Dr. C. T. Maitland, and deals with
the important subject of Rheumatism in Childhood.
This disease frequently causes damage to the heart, and it is estimated that about 50 per cent,
of the mortality due to heart disease is primarily caused by Rheumatic infection.
During the year 1926, 284 deaths, out of a total of 1,651, in Willesden, or more than 1 out of
every 6 deaths was due to Heart Disease or Rheumatic Fever.
Dr. Maitland indicates the important part that the School Medical Service can play in dealing
with Rheumatism in Childhood, and indicates the necessity for the education of the public in regard
to the manifestations of early Rheumatism and Heart Disease, the need for prolonged treatment
in the early stage and the importance of the choice of an occupation for a child who has suffered
from Heart Disease during school age.
Dr. Maitland's article is well worthy of close perusal by the Council and the public.
Diphtheria in the Stonebridge Area.—The report on Diphtheria in the Stonebridge area
between 1st January, 1926, and 1st July, 1926, appears as Appendix I, and is written by Dr. Alice Gray.
Dr. Gray has carefully analysed the various factors which may conceivably have been at work
in giving rise to 133 cases of Diphtheria with 13 deaths in this area during the first six months of the
year 1926.
Dr. Gray concludes that the most important factor in the spread of disease is personal infection,
and that this factor is a special menace in a family in which a case occurs and is not promptly brought
to the notice of the doctor so that it may be removed to Hospital.
Dr. Gray finally points out that many of the methods for the control of Diphtheria now in
vogue are not of great value, and very properly emphasises the importance of utilising the newer
methods for Diphtheria prevention, namely, Schick testing and immunisation.
STAFF
In January, 1926, the Council granted permission to the Medical Officer of Health to serve
on the Departmental Committee on Vaccination at the request of the Minister of Health.
The Committee consists of : Sir Humphry Rolleston (President of the Royal College of
Physicians), Chairman; Dr. F. R. Blaxall, Dr. G. F. Buchan, Dr. A. E. Cope, Dr. Mervyn H. Gordon,
Professor J. C. G. Ledingham, and Mr. J. R. Perdrau, with Dr. J. R. Hutchinson, a Medical Officer
of the Ministry of Health, as Secretary.
The Committee has been set up by the Minister with the following terms of reference:—
" . . . to enquire into and from time to time report on:—
(1) Matters relating to the preparation, testing, and standardisation of vaccine lymph;
(2) The practical methods which are available in the light of modern knowledge to
diminish or remove any risks which may result from vaccination;
(3) The methods of vaccination which are most appropriate to give protection against
risk of smallpox infection in epidemic and non-epidemic periods;