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83
younger patients the symptoms may easily be confused with those
of Tubercular Meningitis, and this will be shown in the accompanying
list of cases notified.
Owing to the difficulty in diagnosis, many cases are not notified
till some time after the onset, and for that reason, and to make the
account of the cases complete, I am including cases notified early
in 1926.
The problem I had to face was that by far the great majority
of the cases were being notified by one Practitioner, also that they
were occurring in one part of the district, largely in an area a mile
in radius from the "Bell." No particular attention was given to
the earlier cases beyond the investigation necessary upon notification.
As the cases developed in number, I tried to get clinical
notes either through the medical men themselves or as a result of
personal investigations. With the increasing numbers I tried to
explore various items with a view to throwing any light on the
prevalence
Various articles of food particularly, were investigated but the
investigation led to nothing of any value whatever. One outstanding
item was the occurrence of a batch of definite cases near Pownall
Gardens.
The problem of the repeated notification of cases by
one Practitioner was, if he was correct, how did it happen
that practically none of the other Practitioners were seeing any
cases, in other words there must have been a large number of mild
cases being missed. Owing to this, I saw several cases myself and
in all but two, I was of the opinion that they were definite, but for
the most part mild cases of Encephalitis Lethargica.
So important was it to establish or refute the diagnosis that
I got Dr. Parsons from the Ministry of Health to see the same
cases. In the meantime, the Practitioner withdrew the notification
himself of one of the cases I did not confirm, and by Dr. Parsons'
Nit, fresh symptoms had supervened in the other case making the
diagnosis evident.