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Twelve cases were found to be suffering from Diphtheria and
Scarlatina, though notified as Scarlet Fever only. In eight cases
the diagnosis of Scarlet Fever was not confirmed. One patient,
admitted with a septic foot, developed phlebitis of the internal
saphenous vein, with secondary abscess in calf of leg, but made a
good recovery.
Three cases were transferred to Whipps Cross Hospital for operative
treatment, viz., mastoid disease, empyæma and retro-pharyngeal
abscess.
Staff.—Members of the Staff were warded during 1930 for the
following complaints:—Tonsillitis, 6; Scarlet Fever, 2; Rheumatism
and Tonsillitis, 1; Rheumatism, 2.
Swabs.—2,854 swabs were taken and examined during the year
in the laboratory at the Hospital.
Operations at Hospital.—Tonsillectomy, Tracheotomy, one
each.
Cross Infection.—40 cases were transferred from Diphtheria
wards to the Cubicle Block with scarlatiniform rashes, and in 15
cases the diagnosis of Scarlet Fever was confirmed.
Four cases were removed from Scarlet Fever wards to the Cubicle
Block, diphtheritic infection being present in nose or throat.
Owing to the exceedingly transient character of many Scarlet
Fever rashes and the absence of other concomitants of the disease,
many cases escape detection and a certain amount of cross-infection
is inevitable.

Use of Antitoxin in Scarlet Fever.—Serum in the great majority
of cases cuts short pyrexia, malaise and rash, shortens convalescence,
and when given early reduces the occurrence of complications. In a
small percentage of cases the effect is dramatic and one may then
infer that the antitoxin had been prepared from a similar strain of
scarlatinal streptococcus to that with which the patient has been
infected. The dosage was a single intramuscular injection of 10c.es.
In three cases there was local reaction, two cases only amounting
to induration and redness at the site of injection. In the third case
an abscess formed, but this was in a very septic case. One case of
typical serum sickness occurred."
Duration of Treatment.—The average duration of treatment in
Hospital was as follows:—
Diphtheria, 47.1 days.
Scarlet Fever, 42.2 days.
Mixed infections, 44.8 days.