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EPIDEMIC POLIOMYELITIS.
EPIDEMIC POLIOMYELITIS.
637
bombs, being himself wounded by
the boys at Cheltenham College during the month an explosion later that his house had been of October, 1917. The precise source of the inbombed in his absence, his wife or members - of fection was not definitely determined, but it is family being also hurt. If he were found, quite thought very probable that it was brought to the imprudently we admit, to have failed to insure to college by a returning schoolboy at the conclusion The first of the cases the fullest extent, or to have allowed his insurance of the summer vacation. to lapse, we should certainly feel impelled to sup- had a fatal termination, but the other two port the view, which no doubt he would hold, that recovered. There were ten notifications of poliothe State ought at least to help him to bear his myelitis in Cheltenham town during 1916, but loss. It will be recognised that the case we have apparently no connexion existed between these put forward is not wholly imaginary, and because cases and those at the college in 1917. The publiof it, and others, we sympathise in the abstract cation of these three reports serves, among other with the views put forward by the Committee on things, the useful purpose of reminding medical men that poliomyelitis is liable to occur, sporadiWar Damage. cally or otherwise, in any part of the country, and EPIDEMIC POLIOMYELITIS. that practitioners should be on their guard against IN this country, happily, we have had so far no overlooking mild, abortive, or anomalous cases severe or widespread epidemics of acute poliowhich, if not properly dealt with at once, might myelitis, such, for example, as that which swept diffuse the infection in the locality and give rise to a serious epidemic. Epidemic poliomyelitis is, over the State of New York two years ago, and which, in a population of about 10 ½ millions, as our readers are aware, one of the saddest of attacked no fewer than 13,164 persons, most of diseases, since the tender-aged victims who survive them under 5 years of age, of whom 3331, or about the attack are often left permanently crippled or 25 per cent., died; and among those who recovered deformed. a considerable proportion were left paralysed for ULSTER AND THE MEDICAL NEEDS OF THE life. In England the manifestations of the disease, ARMY. while not uncommon, have hitherto been on a of’ small scale. The total number comparatively AT the first meeting of the Ulster Medical Society cases notified in 1917 was 357, distributed widely for the session 1918-19, held in the Belfast Medical The Institute, when Dr. W. Donnan, as retiring President, over the country in small groups of cases. largest outbreaks in recent years occurred in introduced his successor, Dr. J. Colville, Dr. F. Devon and Cornwall in 1911, and were carefully Goodbody made a strong appeal for doctors for the investigated on behalf of the Local Government front owing to the great necessity for them during Board by Dr. R. J. Reece.! Three localised out- the present Allied offensive. The medical probreaks of epidemic poliomyelitis reported to the fession in Ireland is being strongly pressed for Board during 1917 were made the subject of fully qualified practitioners with the Army, and the special inquiry by medical inspectors. The Queen’s University of Belfast has definitely decided three reports have now been issued together, to hold a special medical degree examination at the along with a prefatory note by Dr. R. J. Reece, end of November, so that there shall be no delay The until the usual degree examinations in March of Assistant Medical Officer to the Board.2 first report is by Dr. A. S. MacNalty and deals with next year. But they have made certain clear an outbreak, comprising 42 cases and 3 deaths, in conditions :the Esher and the Dittons urban district and in the 1. Every candidate before being admitted must sign a. adjoining Epsom rural district, 33 attacks being document that in the case of men they will go to the front, referred to the former and 9 to the latter. Twenty and in the case of women that they will place their services of the cases suffered from definite paralysis, in 12 at the disposal of the War Office. 2. Those candidates who pass must provide evidence of whom, when last seen, the paralysis still per- before their degrees are conferred that they have " signed sisted. The spread of the disease generally was on " with the War Office, otherwise their degrees will be from person to person. Dr. MacNalty in his report forfeited. gives a diagram representing graphically the spread " The possibility of getting young medical men in of the infection and the grouping of the cases. Mild Ireland has been rendered doubtful," says our or so-called "abortive" cases occurred side by side Belfast correspondent, " because there is no with paralytic cases in the same households; such that if a young doctor throws up his guarantee mild cases when unrecognised probably played a practice and goes to the front he will not on not inconsiderable part in diffusing the infection. his return find his patients in the hands of others The first attacks were reported in mid-July and the will not be very keen to give them back." Our outbreak lasted until the end of August. The correspondent proceeds : second report is by Dr. H. A. Macewen and relates The bureaucratic authorities in of the petrolto the occurrence of 11 cases of acute poliomyelitis supply are cutting down the amountscharge of spirit to doctors, in the borough of Cambridge and in its vicinity with the natural result that, in addition to the amounts smaller and often much poorer, the mileage of the during the autumn of 1917. In this instance also being diminished. The consultants and those the malady appears to have been spread by personal cars is being attending the military in hospitals and camps are finding infection. The origin of this local outbreak was that it is impossible to get through work with the difficult to trace, and no connexion between it and a diminished supply of such frequently poor petrol; while men-who would be willing to do the extra work of previous occurrence of the disease could be dis- older doctors, so as to let the latter off to the Navy and younger covered. There was only 1 death among the 11 cases. Army-realise they could not, with their present petrolThe third report is by Dr. J. P. Chandler, and is supply, do the work. What makes it specially aggravating is concerned with an investigation of three cases of that every day civil officers are using petrol, and ambulances are seen running about with, at times, some vegetables or acute anterior poliomyelitis which occurred among clothes (washed or soiled), as the case might be, from one
o6nd being informed
--
____
who "
1
2
THE LANCET,
1912, i., 450.
Reports to the Local Government Board on Public Health and Medical Subjects (New Series, No. 120). Further Reports and Papers on Epidemic Poliomyelitis. H.M. Stationery Office. Pp. 27. Price 1s. net.
military hospital to another. The whole train service is so greatly restricted that it is of little use to doctors. Owing to the inadequate supply of doctors the Dublin corporation has demanded the release of several medical been deported and interned."
men
who have
637
bombs, being himself wounded by
the boys at Cheltenham College during the month an explosion later that his house had been of October, 1917. The precise source of the inbombed in his absence, his wife or members - of fection was not definitely determined, but it is family being also hurt. If he were found, quite thought very probable that it was brought to the imprudently we admit, to have failed to insure to college by a returning schoolboy at the conclusion The first of the cases the fullest extent, or to have allowed his insurance of the summer vacation. to lapse, we should certainly feel impelled to sup- had a fatal termination, but the other two port the view, which no doubt he would hold, that recovered. There were ten notifications of poliothe State ought at least to help him to bear his myelitis in Cheltenham town during 1916, but loss. It will be recognised that the case we have apparently no connexion existed between these put forward is not wholly imaginary, and because cases and those at the college in 1917. The publiof it, and others, we sympathise in the abstract cation of these three reports serves, among other with the views put forward by the Committee on things, the useful purpose of reminding medical men that poliomyelitis is liable to occur, sporadiWar Damage. cally or otherwise, in any part of the country, and EPIDEMIC POLIOMYELITIS. that practitioners should be on their guard against IN this country, happily, we have had so far no overlooking mild, abortive, or anomalous cases severe or widespread epidemics of acute poliowhich, if not properly dealt with at once, might myelitis, such, for example, as that which swept diffuse the infection in the locality and give rise to a serious epidemic. Epidemic poliomyelitis is, over the State of New York two years ago, and which, in a population of about 10 ½ millions, as our readers are aware, one of the saddest of attacked no fewer than 13,164 persons, most of diseases, since the tender-aged victims who survive them under 5 years of age, of whom 3331, or about the attack are often left permanently crippled or 25 per cent., died; and among those who recovered deformed. a considerable proportion were left paralysed for ULSTER AND THE MEDICAL NEEDS OF THE life. In England the manifestations of the disease, ARMY. while not uncommon, have hitherto been on a of’ small scale. The total number comparatively AT the first meeting of the Ulster Medical Society cases notified in 1917 was 357, distributed widely for the session 1918-19, held in the Belfast Medical The Institute, when Dr. W. Donnan, as retiring President, over the country in small groups of cases. largest outbreaks in recent years occurred in introduced his successor, Dr. J. Colville, Dr. F. Devon and Cornwall in 1911, and were carefully Goodbody made a strong appeal for doctors for the investigated on behalf of the Local Government front owing to the great necessity for them during Board by Dr. R. J. Reece.! Three localised out- the present Allied offensive. The medical probreaks of epidemic poliomyelitis reported to the fession in Ireland is being strongly pressed for Board during 1917 were made the subject of fully qualified practitioners with the Army, and the special inquiry by medical inspectors. The Queen’s University of Belfast has definitely decided three reports have now been issued together, to hold a special medical degree examination at the along with a prefatory note by Dr. R. J. Reece, end of November, so that there shall be no delay The until the usual degree examinations in March of Assistant Medical Officer to the Board.2 first report is by Dr. A. S. MacNalty and deals with next year. But they have made certain clear an outbreak, comprising 42 cases and 3 deaths, in conditions :the Esher and the Dittons urban district and in the 1. Every candidate before being admitted must sign a. adjoining Epsom rural district, 33 attacks being document that in the case of men they will go to the front, referred to the former and 9 to the latter. Twenty and in the case of women that they will place their services of the cases suffered from definite paralysis, in 12 at the disposal of the War Office. 2. Those candidates who pass must provide evidence of whom, when last seen, the paralysis still per- before their degrees are conferred that they have " signed sisted. The spread of the disease generally was on " with the War Office, otherwise their degrees will be from person to person. Dr. MacNalty in his report forfeited. gives a diagram representing graphically the spread " The possibility of getting young medical men in of the infection and the grouping of the cases. Mild Ireland has been rendered doubtful," says our or so-called "abortive" cases occurred side by side Belfast correspondent, " because there is no with paralytic cases in the same households; such that if a young doctor throws up his guarantee mild cases when unrecognised probably played a practice and goes to the front he will not on not inconsiderable part in diffusing the infection. his return find his patients in the hands of others The first attacks were reported in mid-July and the will not be very keen to give them back." Our outbreak lasted until the end of August. The correspondent proceeds : second report is by Dr. H. A. Macewen and relates The bureaucratic authorities in of the petrolto the occurrence of 11 cases of acute poliomyelitis supply are cutting down the amountscharge of spirit to doctors, in the borough of Cambridge and in its vicinity with the natural result that, in addition to the amounts smaller and often much poorer, the mileage of the during the autumn of 1917. In this instance also being diminished. The consultants and those the malady appears to have been spread by personal cars is being attending the military in hospitals and camps are finding infection. The origin of this local outbreak was that it is impossible to get through work with the difficult to trace, and no connexion between it and a diminished supply of such frequently poor petrol; while men-who would be willing to do the extra work of previous occurrence of the disease could be dis- older doctors, so as to let the latter off to the Navy and younger covered. There was only 1 death among the 11 cases. Army-realise they could not, with their present petrolThe third report is by Dr. J. P. Chandler, and is supply, do the work. What makes it specially aggravating is concerned with an investigation of three cases of that every day civil officers are using petrol, and ambulances are seen running about with, at times, some vegetables or acute anterior poliomyelitis which occurred among clothes (washed or soiled), as the case might be, from one
o6nd being informed
--
____
who "
1
2
THE LANCET,
1912, i., 450.
Reports to the Local Government Board on Public Health and Medical Subjects (New Series, No. 120). Further Reports and Papers on Epidemic Poliomyelitis. H.M. Stationery Office. Pp. 27. Price 1s. net.
military hospital to another. The whole train service is so greatly restricted that it is of little use to doctors. Owing to the inadequate supply of doctors the Dublin corporation has demanded the release of several medical been deported and interned."
men
who have