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26
of the hospital cases. The question is so important that it is necessary
to again record the fact that almost every case of diphtheria
could be saved if anti-toxin treatment were begun sufficiently early.
Every patient who is suspected to be suffering from diphtheria should
be given anti-toxin without delay and without waiting for bacteriological
confirmation of the diagnosis.
Since 1907 the following notice has been issued to medical men,
but so far comparatively few have availed themselves of the offer:—
"EARLY TREATMENT OF DIPHTHERIA."
"As success in treatment is dependent on antitoxin being administered
at the onset of the disease, patients who present clinical
symptoms of diphtheria should be sent to the Borough Hospital or
receive antitoxin at home, without waiting the result of the bacteriological
examination."
"Antitoxin may be obtained at the Public Health Department,
Town Hall, during office hours, and at the Borough Hospital at
other times. The price is 2s. 6d. per 2,000 units, but preliminary
doses for patients who will be admitted to hospital if the diagnosis
is confirmed, may be obtained free of cost if special application be
made to the Public Health Department or to the Borough Hospital,
Waddon Marsh Lane, Croydon."
ENTERIC FEVER.
Twenty-one cases were notified, and three deaths from this
disease were registered during the year. Eleven cases were removed
to hospital, and of these three were subsequently found to be suffering
from some other complaint, viz.:— One from enteritis, one from
pleurisy with effusion, and one from ulcerative colitis. There were
thus iS cases of supposed enteric fever which required investigation.
Of these four were due to personal infection from a preceding case
in the same house. In the remaining fourteen cases no source
of infection could be discovered, but in three instances the blood
reaction was negative, and there is considerable doubt as to the
correctness of the diagnosis. One of the patients was a nurse at the
Croydon Infirmary, the source of whose infection was not definitely
traced. Possibly she was infected from a. chronic "carrier" among
one of the patients. Another of the notified patients was a missed
case which had been admitted to the General Hospital for pneumonia,
and the nature of the illness was only discovered through
attention being directed by the investigations of the Health
Department into the illness of a relative who was notified as
suffering from enteric.