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سيليسيا

PUBLIC RECORD OFFICE

Reference :-

C.O. 885

ALLY WITHOUT PERMISSION OF THE BE REPRODUCED PHOTOGRAPHIC- COPYRIGHT PHOTOGRAPH-NOT TO

22 PUBLIC RECORD OFFICE, LONDON

37256

SIR

54

No. 46.

JAMAICA.

THE GOVERNOR to THE SECRETARY OF STATE.

(Confidential.)

(Received 25 November, 1912.)

King's House, Jamaica, 7 November, 1912. I HAVE the honour to acknowledge the receipt of your Confidential despatch of the 9th of September last, having reference to Captain Potter's report on the subject of vomiting sickness in Jamaica.

2. Since my return to the Island from leave of absence I have given careful consideration to Captain Potter's report, and to your Confidential despatches of the 2nd May in regard to it, and also to the observations of the Superintending Medical Oflicer, copy of which was transmitted to you in Mr. Cork's Coufidential despatch of the 24th June.§

3. In pursuance of the recommendation conveyed in your despatch of the 2nd May, that the subject matter of Captain Potter's report should be carefully investi- gated and thoroughly threshed out in the autumn, and that meanwhile as much information as possible should be collected in advance, special instructions were issued to the Medical Department in accordance with the minutes written by Mr. Cork, whilst administering the Government, of which transcripts are enclosed, together with the accompanying forms for case histories and post-mortem reports to be used in connection with cases of the disease known as vomiting sickness.

4. It was, as you suggest in the first paragraph of your Confidential despatch of the 9th September,* deemed by Mr. Cork undesirable to publish Captain Potter's report pending further investigations of the disease, but I concur in the view you express that the report cannot properly be kept confidential, and should be published in due course. In the meanwhile I have asked your authority by my telegram of the 1st ultimo to publish an extract from the minutes of the meeting of the Tropical Diseases Research Fund Advisory Committee, copy of which was transmitted in your Confidential despatch of the 2nd May last, which would indicate the nature of Captain Potter's conclusions, and the judgment of the Committee with regard to it, and I received in reply your telegram of the 15th ultimo..

5. In your despatch of the 9th September* you enquired whether I should wish you to cause either the London or the Liverpool School of Tropical Medicines to be approached with a view to their sending out an expedition in the autumn to make further investigation. Should any such expedition be sent out all possible facilities would be given by this Government for the advancement of its operations, but, for reasons which I shall endeavour to explain, I have come to the conclusion that it would not be justifiable to propose to the Legislative Council a further vote for the expenses of such investigation.

6. I feel it right to express to you freely my personal judgments with regard both to Captain Potter's work and to the conclusions of his report. These judgments are those of an Administrator, and not a professional medical authority. difficult to invite from members of the medical profession frank criticisms or expres- It is sions of opinion upon the work of a colleague in that profession, and I have preferred not to challenge any direct expression or opinion from any of my professional advisers at this stage in regard to Captain Potter's methods or his conclusions.

your

7. In Confidential despatch of the 17th September** you enquired whether Captain Potter directly led this Government to believe that a report on peripheral neuritis, as well as on vomiting sickness, would be furnished by him, or whether it' was assumed that he would do so in view of the terms of his appointment, and also whether Captain Potter obtained the concurrence of the Government in his leaving the Island without making any investigation of peripheral neuritis.

• 21980; not printed.

[31128: not printed.

↑ West Indian No. 187.

32288; not Įrinted.

6370: not printed.

** 28416: not printed.

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8. In reply to these enquiries I beg leave to refer you to the terms of

my tele- gram of the 14th of October, 1910,* and to my despatch, No. 419, of the 20th of the same month, and of your reply, No. 346, of the 23rd of December, 1910,‡ and its enclosures, which did not indicate any suggestion of question that such a report was expected from Captain Potter. I also beg leave to transmit, for your information, a copy of a letter from the Superintending Medical Officer, covering one from Captain Potter, in which the latter stated that he would prepare his report on peripheral neuritis on his arrival in England, and that he hoped to have it ready in about a couple of months later than his report on vomiting sickness.

9. Captain Potter did not obtain the concurrence of the Government in his leaving the Island without making any investigation of peripheral neuritis, but I may say that, from such observation as I had been able to make of his proceedings, it had not appeared to me that he had taken sufficient trouble to obtain the materials for doing so, and that, although I naturally expected to receive a report on the subject, I did not, in fact, expect that a very valuable one would be obtained, and I did not consider that there would be any advantage in encouraging Captain Potter to remain longer in the Island at the cost of this Government.

10. I was aware, or at any rate I acquired the impression, that Captain Potter was not diligently investigating peripheral neuritis, whereas he had, in my opinion, time and opportunity to do so, as cases are to be met with in almost every hospital and poor-house of the Island, and it appeared to me that he could, without any material interruption of his studies of vomiting sickness, have made a considerable body of observations on the subject of the other disease.

11. Turning now to Captain Potter's report on vomiting sickness - I observe that he dismisses very summarily the diagnosis of the disease commonly so-called as cerebro-spinal meningitis. It is a fact, as he observes, that the best medical opinion in this Island had, in former periods, generally, or at any rate, frequently, diagnosed vomiting sickness as cerebro-spinal meningitis, but the diagnosis has not been verified by bacteriological research. It has, however, been possible for the Government recently to obtain bacteriological investigation in certain cases of what is known as vomiting sickness. These examinations were conducted by Dr. Scott, the Govern- ment Bacteriologist in this Island, a copy of whose report thereon I enclose, and appear to prove conclusively that in the cases dealt with the disease was cerebro- spinal meningitis. I also enclose copy of certain observations made by the Superin- tending Medical Officer since his recent return from leave of absence upon this report. I would also invite reference to Dr. Scott's report on the work of the Government Laboratory for the six months ended September 30th, copy of which I transmitted to you in my despatch, No. 381, of 31st ultimo. § in paragraph B 2 of which these cases are again fully described.

12. Captain Potter's report does not make mention of any bacteriological examinations of cerebro-spinal fluid having been made by him. He contents himself by saying that the absence of any definite post-mortem appearance of inflammation in any of the examinations recorded speaks against the accuracy of the diagnosis, but I have been informed that, in cases so speedily fatal as most cases of vomiting sickness in children are, there may be no time for severe inflammation to be set up.

13. Captain Potter further argues that had such cases been cerebro-spinal meningitis some would have run a more prolonged course, sequelæ, such as paralysis, blindness, and deafness would be expected, and the post-mortem examinations would have shown definite inflammatory changes in the meninges.

It appears to me conceivable that had Captain Potter investigated the subject of peripheral neuritis he might possibly have been able to trace the paralysis, blind- ness, and other nervous degradations exhibited in that affection in some cases to a history of cerebro-spinal meningitis.

14. Captain Potter expresses the opinion that the majority of deaths ascribed to the so-called vomiting sickness are due to yellow fever. He considers that the whole of the list in Appendix E. were cases of yellow fever, and he discusses at some length the question of the endemicity of that disease in Jamaica. It would not appear that he had discussed this question with anyone familiar with the nosology of the Island, which might have saved him a great deal of trouble, but he seems to have approached it as a new problem, and to have built up his impressions on a study of Departmental Reports.

31659: not printed.

† 33916: not printed,

† 17632: not printed. No. 1 in Appendix VI to [C1, 6669).

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