The theory and practice of hygiene (Notter and Firth) revised and largely re-written / by R.H. Firth.

  • Notter, J. L. (James Lane), 1843-1923.
Date:
1908
Catalogue details

Licence: In copyright

Credit: The theory and practice of hygiene (Notter and Firth) revised and largely re-written / by R.H. Firth. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

    632/1096 (page 598)
    accurately determine what the mortality from this disease really is, as it 13 not unlikely that true cerebro-spinal fever is of more frequent occurrence than is generally supposed, owing to errors of diagnosis between this and tubercular meningitis or indeterminate fevers. The deaths recorded annually in England and Wales as due to this disease, during the twenty years 1874-1893, have ranged from 13 in 1893 to 68 in 1878. Influence of Sex, Age, and Race.—It is difficult to find any difference m regard to the incidence of the disease upon the two sexes. As regards age, it usually attacks those approaching puberty, or in early adult life: it has been known, however, to occur in persons of aU ages, though certainly rare among those beyond middle life. The evidence in respect of race mdicates it to make no distinctions. . . .-i Effects of Climate and Season.—Except for its occurrence m 1^1J1, m tne unusually cool year 1885, we have no accounts of the prevalence of this disease in tropical climates. In all countries in which it has been observed as an epidemic, this has usually occurred in either winter or spring, that is, in the coldest seasons of the year. . ^i . -,. Etiology—Owing to the frequent manifestations of this disease m an epidemic form in pubhc institutions, the earher views regarding it indicated infection as a prominent factor in its diffusion. A close analysis of the more recent outbreaks indicates that cerebro-spinal fever varies considerably as regards infectiveness, and that, if directly communicable from person to person, it is communicable only in a very low degree (Simon) It not directly communicable, there are strong grounds for regarding it at least as being readily transported from place to place by infected persons and tl^gs. Eagge, quoting the views of Ferguson, veterinary _ surgeon to the Privy CouncU in Ireland, suggests that a contagious principle is given off by the sick but that it has to undergo some transformation or intermediate stage of its development, possibly in another animal, before it can miect a hiiman being and that on each occasion when the disease has prevailed m Ireland, it has co-existed with an epizootic of the same nature among pigs and dogs Arguing from analogy with what we know to be the case m respect of other tisSI and bearing in mind that this affection has ^ tendency to prevad under conditions of overcrowding or defective ventilation, and to recur m districts which have suffered from previous epidemics, we are Justified m believing that the cause of the disease is a micro-organism belongmg to the class of facultative parasites, and as such capable of thrivmg and Biultiplying outside human or animal bodies. At present, this microbe has not been identified. Importance has been attributed by some observers to dampness of soil as an etiological factor in this disease, even so far as to allege that it is of malarial origin: as Hirsch has pointed out, the geographical distribution of the affection does not support this view. , , • ;i Prevention.-In our present condition of defective knowledge m regard to the exact origin of this disease it is difficult to formulate prophylactic la ures Isolation does not seem to be required, and we do not know what to disinfect. , Eree ventilation, good food, and avoidance of fatigue appear most essential. CHICKEN-POX. It was only towards the end of the last century that this disease was It was only 10 g^iall-pox: but beyond a certam superficial clearly d^^^^^g;;^i, eommon between the two diseases. Cliicken- ^r^^Z:^^^^ very often coincides with epidemics of