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its perambulator, striking the left side of the forehead,
causing a lump, but "he soon seemed all
right." About three weeks later the mother noticed
that when he cried his left eye remained open. On
sleeping the eye-lid closed, but gradually opened a
little. He did not seem at all ill. On August 21st
he was taken to the London Hospital, and for a short
time attended twice a week. The case was notified
by the Hospital on August 23rd, and by the middle
of September had so improved that only on crying
could anything unusual be noticed. The patient was
breast-fed till nearly a year old, and is the youngest of
six children, all of whom are well. There is good
family history.
With regard to the steps taken to prevent the spread of the
disease the usual precautions relating to infectious disease generally
were given, but it was not considered advisable to keep the
other children away from school in view of the improvement
that had taken place in each case prior to investigation.
With regard to the steps taken to verify the diagnosis the
Council has made arrangements for the bacteriological examination
of material from patients attacked should the same be
desired, but such examination was impossible in the first case
which removed to Barking, and in the two cases treated at the
London Hospital it was not considered necessary to make the
offer.
Case 4.—W. H., aged 6 years, of Tinto Road. Family history:
Father, mother, and three much older children
alive and well; paternal grandmother died of cerebral
haemorrhage, maternal grandfather died of "creeping
paralysis." Past history: The child had apparently
not been very strong since an attack of measles at