M (1) 10
Cerebro-spinal fever, diphtheria, and dysentery have not been more in evidence than they were in the earlier period. Influenza had been for many years before 1918 a comparatively slight cause of sickness, but since that year it has been a regular visitor, frequently in epidemic form, and affecting all nationalities. It occurs at all times of the year and seems to be independent of the condition of the weather. The number of cases reported from the different institutions was 972 for the year. There were 1,328 in 1920. The number of deaths reported as due to influenza was 542 and 303, for the last two years respectively. Except in the case of small-pox and paratyphoid fever, the amount of infectious diseases in the year under review compares favourably with the years preceding; this is shown in tabular form :-
Year Plague Small-pox Cerebro-spinal fever Cholera Diphtheria Typhoid Paratyphoid 1917 38 595 0 0 69 188 7 1918 266 32 1,232 0 118 247 2 1919 464 27 269 46 50 133 3 1920 138 34 158 6 76 118 14 1921 150 191 125 5 85 115 79Cerebro-spinal fever.-This disease appeared in epidemic form in 1918; the number of deaths caused by it in each of the four years 1918-1921, being 968, 204, 103 and 73, respectively. As usually happens where the exact conditions in which a disease originates are unknown, overcrowding and defects in sanitation are assumed to be the causes. But certain peculiarities in the distribution and extension of this disease seem to imply that although indifferent sanitation may be one of the factors concerned, it is not to be the governing factor in its causation. For cerebro-spinal meningitis is often distributed irregularly even amid conditions of overcrowding and squalor; and, it has broken out not infrequently among townspeople and soldiers, particularly in barracks, under circumstances in which insanitary conditions could be excluded, or, at all events, were not discoverable. Or it may be confined within narrow limits, although the defects of hygiene may be as great round about as in the areas affected. Epidemics have occurred which were confined to the inmates of one institution, to one regiment in a garrison, even to one block of houses. Overcrowding then seems to have no special significance in causing the disease, but only a general one of the same value that it has for many other infective diseases by providing suitable conditions for their development.
As to its contagiousness, the observation is commonly made that attendants on the sick, even those in close or continuous contact...
M (1) 10
cerebro-spinal fever, diptheria, and dysentery have not been more in evidence than they were in the earlier period. Influenza had been for many years before 1918 a comparatively slight cause of sickness, but since that year it has been a regular visitor, frequent- ly in epidemic form, and affecting all nationalities. It occurs at all times of the year and seems to be independent of the condition of the weather. The number of cases reported from the different institutions was 972 for the year. There were 1,328 in 1920. The number of deaths reported as due to influenza was 542 and 303, for the last two years respectively. Except in the case of small-pox and paratyphoid fever, the amount of infectious diseases in the year under review compares favourably with the years preceding; this is shown in tabular form :-
Year.
Plagne.
Small-pox.
Cerebro-spinal
fever.
Cholera.
Diptheria.
Typhoid.
Paratyphoid,
1917
38
595
0
0
69 188
7
1918
266
32
1,232
0
118
247
2
1919
464
27
269
46
50
133
3
1920
138
34
158
6
76
118
14
1921
150 191
125
5
85 115
79
Cerebro-spinal fever.-This disease appeared in epidemic form in 1918; the number of deaths caused by it in each of the four years 1918-1921, being 968, 204,103 and 73, respectively. As usually happens where the exact conditions in which a disease. originates are unknown, overcrowding and defects in sanitation are assumed to be the causes. But certain peculiarities in the distribution and extension of this disease seem to imply that al- though indifferent sanitation may be one of the factors concerned, it is not to be the governing factor in its causation. For cerebro- spinal meningitis is often distributed irregularly even amid conditions of overcrowding and squalor; and, it has broken out not infrequently among townspeople and soldiers, particularly in barracks, under circumstances in which insanitary conditions could be excluded, or, at all events, were not discoverable. Or it may be confined within narrow limits, although the defects of hygiene may be as great round about as in the areas affected. Epidemics have occurred which were confined to the inmates of one institution. to one
regiment in a garrison, even to one block of houses. Overcrowding then seems to have no special significance in causing the disease, but only a general one of the same value that it has for many other infective diseases by providing suitable conditions for their development.
As to its contagiousness, the observation is commonly made that attendants on the sick, even those in close or continuous con-
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