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SOCIETY OF MEDICAL OFFICERS OF HEALTH.

JAN. 10TH.

MR. ARMSTRONG, PRESIDENT, IN THE CHAIR.Notification of Infectious Diseases.

THE meeting was devoted to the discussion of questionsarising out of the correspondence that had passed betweenthe Society and the Local Government and MetropolitanAsylums Boards on the Notification of Infectious Diseases.The gravest complaint was that since the discontinuance ofthe weekly returns of admissions into the hospitals of theAsylums Board, formerly supplied to medical officers ofhealth, a large number of cases remained unnotified, thesanitary authorities being consequently unable to take thenecessary measures for the removal of insanitary conditionsto which these cases might have been due, or to provideagainst the further spread of infection. Among such caseswere, as Dr. Dudfield pointed out, those admitted intogeneral hospitals or sent from these to those of the Board,as well as such as entered the latter hospitals voluntarily.Dr. Findlay read a correspondence that had passed betweenthe authorities of Middlesex Hospital and the LocalGovernment Board. As to the interpretation of the clauseof Sec. 3 exempting from the duty of notification " hospitalsin which persons suffering from infectious diseases werereceived," which they were informed by the board extendedonly to in-patients, cases occurring among the out-patientsto be notified to the medical officers of health of their re-spective districts. But, as Dr. Findlay remarked, manycases of diphtheria and enteric fever were admitted intogeneral hospitals, the sanitary authorities of the districtswhere the disease had been contracted remaining ignorantof their existence. Dr. Willoughby was of opinionthat the legal advisers of the Local Government Boardseemed to be under the impression that patients, whenwithin the walls of a hospital, were no longer dangerous tothe community, forgetful of the fact that their illnessmight have been caused by the conditions of their dwellingscalling for removal, and that measures for disinfection &c.might be required. He suggested that the duty of noti-fication should extend to "’ all cases of infectious diseaseadmitted into any hospital whatever, except such as hadbeen received on the certificate of a medical practitioner."This proposition was accepted unanimously, but Dr. Cor-field would include cases, as of erysipelas, appearing inpatients already in hospital, since these might be caused bysanitary defects in the buildings, which ought not, he con-sidered, to be exempt from the control of the sanitaryauthority. Dr. Corfield then stated that the School Boardhad requested the sanitary authorities to inform them of allcases of infectious diseases occurring in families fromwhich children attended any of their schools. The de-sirability of such notification was unanimously approved,but a long discussion ensued as to the best method ofcarrying it out. Dr. Willoughby explained that 30 percent. of the children in London attended voluntary schools,with which the Board had no relation save that of com-pelling their attendance, and that the only practicablecourse would be to report such cases direct to the head-master of each school, whether under the Board or not.In this he was supported by Dr. Newsholme, and theresolution in favour of this course, moved by Dr. News-

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holme, was carried unanimously. ’

MARCH 14TH.

Epidemic Influenza.DR. FRANK G. CLEMOW, who had recently returned from

St. Petersburg, read a paper on Epidemic Influenza, withspecial reference to its etiology as illustrated by the historyof the present and of previous epidemics. Undoubtedrecords existed of a large number of more or less widespreadepidemics from 1510 to 1847, when it last visited thiscountry; but Dr. Theophilus Thompson was not disposed toattach much value to older accounts, and even Hirsch didnot carry his enumeration further back than the year 1173.Dr. Clemow, however, considered that when we found adescription of a pest that attacked almost everyone withfever, cough, catarrh, and pains in the head and limbs,but of which very few died, we were justified in

recognising it as influenza. One such was referred to byHippocrates and Livy about 412 B.C., but more explicitdescriptions had been handed down to us by Bishop

Gregory of Tours in A.D. 591, and by others in the ninthand tenth centuries. During the next three hundred years,only one epidemic seemed to have been noticed-viz., thatof 1173, which extended over Germany, Italy, France, andEngland, but from 1327 onwards they appeared to haverecurred more frequently. While we were so much in thedark as to the pathology and etiology of the disease,Dr. Clemow considered the name innuenza—i.e., some un-known influence-given to it by the Italians of the sixteenthcentury as at least unobjectionable, and better than " catar-rhus contagiosus" or others which assumed its nature orimplied as essentials what were only accidents of the disease.The present epidemic was reported from Siberia in October,and spread over the whole of Russia during November.In the first ten days of December Poland, Austria, Ger-many, Denmark, and Sweden; in the next France, Spain,and the Balkan State3; and in the last Holland, Belgium,Norway, England, and Italy were successively attacked.In the first half of January it extended to Canada and theUnited States, and in the latter to Tunis, Egypt, andPersia ; while within the next month it had appeared inIndia and at the Cape. The progress of the epidemic wasthus from east to west, modified or diverted by mountainranges and seas, and in no relation, if not actually opposedto the direction of the prevailing winds. Accounts, how.ever, had recently been received of its existence in Green-land, Saskachewan, and the Hudson’s Bay territory aslong since as last spring, whence it would seem that it.might have been carried to Siberia, and thus to have made-the entire circuit of the globe. Referring to the meteoro-logical conditions alleged to attend or coexist with epidemics.of iniiuenza, he confessed that it was not possible to arriveat any satisfactory conclusion as to any relation of thenature of cause and effect ; if anything, mild weather inwinter seemed to favour it. The most remarkable pheno-menon of its progress was the rapidity, almost suddenness.with which large numbers of persons, or entire communities.were attacked, exceeding anything observed in the caseof other infectious diseases, and not easily explicableon the ordinary theory of contagion, but apparently suggest-ing aerial conveyance of some kind. As examples, he citedone which came under his personal observation of 220 out,of 260 men employed in a Government establishment atCronstadt being attacked within a few hours, and the his-torical instances of half a million persons being seized in afew days in London in 1847, and of 40,000 in St. Petersburgin 1782, while the thermometer rose between 2 A. M. and 6 P. M.from 470 below to 4° above Fahrenheit’s zero. But whetherordinary personal intercourse could or could not whollyexplain these phenomena, the recorded exemption or other-wise of the inmates and attendants respectively of asylums,prisons, &c., and other observations of a like kind, left nodoubt as to its contagiousness, while they also served to fixthe incubation period at about two days. On the two pro-positions that had been put forward in connexion withinfluenza, that it caused the temporary disappearance ofother diseases, and that it stood in some causal relation,either as a precursor or a consequence of other epidemics,of which cholera most closely concerned us, he stated hisbelief that they were merely the expressions of bare im-pressions, the former being opposed to actual experience,and the latter having no real basis in facts. Two of theEuropean epidemics of cholera, indeed, happened to followor to accompany those of influenza, but in the other threeno such relation had existed, and there was no reason tothink that it would again, except as a simple coincidence.

EPIDEMIOLOGICAL SOCIETY.

WEDNESDAY, MARCH 12TH.SIR THOMAS CRAWFORD, K.C.B., M.D., PRESIDENT, IN

THE CHAIR.

Treatment of Scarlatina.MR. J. B. CuRGENYEN, in introducing the subject of the-

Treatmentof Scarlatina with Oilof Eucalyptus, which hehadpractised for the last twelve months and which he believedto be equally applicable to other infectious diseases, claimedfor it that it was capable of superseding all other curativeand preventive measures, and of rendering unnecessary all

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attempts at isolation of the sick, disinfection, beyond whatit effected itself, of clothing, bedding, furniture, and rooms ;

I and, except so far as better nursing accommodation &c.