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107
of its devastating effect in the Colony. The superintendent of the Governamt Civil Hospital, Dr. C.. Mokanny, has been fully instructed with regard to this method of treatment and
it is advised that he undertake this phase of the motivities
during an epidemia.
3. The Diagnosis of the Disease.
A survey of the course of the epidemio nakes it certain
that numerous cases of epidenio meningitis have occurred but
have escaped detection.
The first reports showing diagnoses of epidemio meningitir
were returned to the Medical Officer of Health, Dr. Gale, on
February 9th. On February 11th, there were reported eight
verified gases. Wince then, cases were definitely diagnosed
as epidemic meningitis. As this disease in epidemio form has
a definite course and as a great number of cases of hemorrha-
gio mallpox were reported previously to February 9th, 1918,
although no distinct epidemic of mallpox was evident at the
time, it is logical to assume that some of these cases were
that of epidēmid meningitis. Indeed, on February 5th and 6th,
four cases of hemorrhagio smallpox were reported; January 28th
to February 5th, eight cases were reported. With the grauter
number of subsequent reports of epidemic meningitis, hemorrha-
gic mallpox censed to be a factor in the daily returns. The
some assumption may apply to the several cases of atypical
enteric fever reported during January,
To this class of "missed" cases, may be added another,
still more important from the point of view of prevention, the
mild and ambulatory cases. For these are the great sources of
spreading the infection. They will be referred to later.
Lumbar puncture is an absolute essential in the treat-
ment and in the recognition of cases of epidemia meningitis. Due to certain objections on the part of the Chinese community
the precedure is not favourably entertained.
(01)
(11)