View report page

52
Polio-myelitis and Polio-encephalitis.—These are diseases which attack the central nervous
system and may give rise to paralysis; in this respect they are comparable with cerebro-spinal
meningitis and encephalitis lethargica. The diseases have long been known, under the name of
"infantile paralysis," as a form of paralysis of which sporadic cases occur, chiefly in children and
less frequently in adults. In recent years they have occurred in epidemic form, and as they are
undoubtedly infectious they have been made compulsorily notifiable. The degree of infectivity,
as in the case of encephalitis lethargica, is of a low order and it is only seldom that association
can be traced between the cases which are notified. One case in a household is rarely followed by
a second.

Zymotic Enteritis or Summer Diarrhœa.—The Borough Council's scheme for control and treatment
has now been in operation for four years—the first year, namely, 1924, from 1st July to 30th
September, and in 1925, 1926 and 1927 from the 1st June to 30th September—and it has not been
found necessary to alter the arrangements under the scheme which were described in my Annual
Report for the year 1925.
The preventive work under the scheme is carried out by the staff of the Public Health Department
assisted by the voluntary and paid workers at the Infant Welfare Centres. For the purposes
of treatment, Dr. Carter is appointed to render medical assistance during the Summer months and
an arrangement has been made with the Kensington District Nursing Association under which the
services of the nurses can be requisitioned for home nursing at any time of the year.
During the year 1927, only forty-one cases of enteritis were notified and of these twenty were
removed to hospital. Dr. Carter visited twenty-one cases in their homes and paid fifty-four visits.
The District Nurses attended forty-eight cases, and paid 437 visits.
It is a splendid testimony to Dr. Carter to be able to record that no case attended by him since
the commencement of the Council's scheme in 1924 has proved fatal. The following is a report
by Dr. Carter giving particulars of cases of enteritis dealt with during the year under review:—
Zymotic Enteritis, 1927.
Last year was peculiarly cool and wet and consequently there was not much of this illness among
infants and children. The Borough Council's scheme, however, has been of great use in bringing to light
several cases of wrong feeding. I saw twenty-one individual cases of enteritis and paid fifty-four visits.
The majority of these suffered from acute dyspepsia with vomiting and diarrhoea. These symptoms quickly
subsided when treatment was commenced within twenty-four hours after onset. I did not send any cases into
hospital myself, but I had the opportunity of seeing several acute cases sent to St. Mary Abbot's Hospital
by other doctors. Amongst these were two cases from the same family in which the Flexner bacillus was
isolated; these being cases of true dysentery and as they were considered to be too infective to keep in the
wards at St. Mary Abbot's Hospital, they were sent to one of the Metropolitan Asylum Board's Hospitals.
The several cases admitted to the hospital had usually been ill for about a week before admission. Dr.
Fenton has continued to accept notifications of all cases of diarrhoea and vomiting. It is impossible to draw
a line clinically between an infective and non-infective type. A child may die from the loss of water from the
body without having any rise of temperature, particularly if the infant is below normal weight before the
onset of the disease.