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43
treatment; and in one case a fortnight beforehand and in two other
cases several weeks beforehand; as in all, the blood pressure was
decidedly high. The two latter were unmarried girls in domestic
service, and the condition was undoubtedly aggravated by the anxiety
consequent on their condition and also by hard work. It was of
interest to note in some of the milder cases of toxaemia the way in
which the blood pressure would fall to a normal level again after a
few weeks of careful dieting and especially of avoidance of meat.
There were three cases of ante-partum haemorrhage. I sent one
of them to the Consulting Ante-Natal Clinic at the Royal Free
Hospital for an opinion on her condition and she was treated with a
course of corpus luteum tabloids and carefully dieted, so as to exclude
meat as an article of diet. She did very well and was confined at home
by a midwife without any further haemorrhage, a doctor being only
summoned at the time of the confinement, because of the fear of
possible haemorrhage. I referred a second case also to the Consulting
Ante-Natal Clinic, as she had had a good deal of bleeding on and off
when I first saw her, and her condition was further complicated by
the presence of endocervicitis. She was transferred from the said
Clinic to the Special Department at the Royal Free Hospital for treatment
of the latter condition and she was admitted for ten days
intensive treatment, which was continued afterwards as an outpatient.
I am glad to say that she did well in spite of occasional recurrences
of bleeding and I kept her under observation and dieted her carefully
and made all arrangements for her confinement in the Borough
Council Ward at New End Hospital in good time. She had a perfectly
normal labour, but the child had a sharp attack of ophthalmia
neonatorum afterwards, in spite of all the most efficient treatment she
had received at the Special Department at the Royal Free Hospital
which had been designed to prevent this. I think there is no doubt
that if she had come to us earlier in pregnancy she could have had a
longer course of treatment. Fortunately, after a stay at St.
Margaret's Hospital with its mother, the little one's eyes recovered
completely. The third case is still under observation and is doing well.
A breech presentation in the last few weeks of pregnancy, was
present in 11 cases. It is important to diagnose these in good time
and to turn them into vertex presentations, as in the case of a first
child, especially, injury from pressure on the unmoulded head is apt to