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As regards treatment for these cases.
It has been a great help in one's work to be so closely associated
with the Tuberculosis Dispensary and the doctors there have been most
helpful in seeing cases in which phthisis was suspected and in advising as
to their treatment. In none of the four cases in which early phthsis
was definitely diagnosed during pregnancy, was it possible to persuade
the mother to leave her family and go to a sanatorium after the birth
of the child. A few weeks by the seaside was the utmost that could be
arranged for the patient to have, after the birth of her child.
At both the Clinics medicine is supplied free to the patients. This
has been a great, help in treating the numerous cases of dyspepsia and
anaemia, &c.
In practically all the cases of dyspepsia carious teeth are present.
In several cases, too, the teeth were few in number, thus rendering mastication
difficult. I have been sending cases to the Dental Clinic at the Health
Institute in Dynham Road, for treatment, but we are now shortly going
to have our own Dental Clinic. Some arrangement will have to be
made I think, whereby the mothers can obtain dentures at a reduced
rate, on a system of weekly payments. So often I find that the real
reason at the back of a mother's mind for refusing to part with some
septic and discolored stumps is that she has no means of replacing her
teeth by false ones.
As regards the two cases of threatened abortion in which specific
disease was present, I persuaded one patient to go to St. Mary's Hospital
Paddington, for injections of salvarsan with most satisfactory results.
It was not possible to persuade the other patient to undergo treatment
by injections. I accordingly treated her with mercurial treatment
by the mouth for some months and the results have been excellent.
As regards the post-patal cases, two were unmarried mothers. In
one case early phthisis developed and I sent her on to the Tuberculosis
Dispensary. In another case, perimetritis was present. In the third
case (a married mother), specific disease was present and I sent her on
to the Garrett Anderson Hospital for Women. The cases that were
not ante-natal were sent on to the latter institution also.
Attendances of patients after their confinements.
I always try to get the patients to come up once or t wice when they
are about again, after the baby is born. In a large number of cases,
this is done. Frequently it is necessary to give the mother a tonic after
the severe strain she has been through. I have had four cases of subinvolution
of the uterus, three after a full time pregnancy and one after
a miscarriage.