View report page

51
MEMBRANOUS CROUP.
The Hospitals Committee, reporting to the Metropolitan Asylums Board on
a memorandum in which attention was called to certain facts connected with
delay in the removal of a case to hospital because it was simply certified as
suffering from membranous croup without the qualification that it was diphtheritic
in nature, said that as far back as 1897 the point as to whether cases of
membranous croup should be admitted by the Board was put to the Local
Goverment Board, who replied that it was advised "that the term membranous
croup per se is not sufficiently definite."
In view of all the circumstances the Committee asked the medical superintendents
of the fever hospitals whether, having regard to their lengthened
experience, cases certified without qualification to be membranous croup ought
to be admitted to the Board's hospitals. The whole 11 unanimously expressed
the opinion that they ought to be.
On the ground of their strong expression of opinion the Committee has issued
intructions that persons certified without qualification to be suffering from
membranous croup arc to be admitted to the Board's hospitals, and resolved to
report the action taken by the Committee to the Local Government Board.
SEPTIC DISEASES: ERYSIPELAS.
The Septic class of diseases, popularly known as blood-poisoning, includes
ervsipelas, pycemia and septicoemia, and puerperal fever.
Whereas erysipeles attacks the surfaces, the skin and mucous membranes,
and the tissues lying beneath, pyœmia and septicoemia affect the deeper parts
and internal organs, the puerperal form commencing in the female pelvis.
Pyaemia and Septicwmia.—The difference between pycemia and septicoemia is
one of degree, the former referring to a subacute or chronic condition of local
septic foci, and the latter to an acute general distribution throughout the body.
These diseases are not included amongst the dangerous infectious diseases
notifiable to the Medical Officer of Health.
Puerperal Fever.—The opinion of the Royal College of' Physicians was sought
by the London County Council, in the year 1898, submitting the question:
"Whether the diseases peritonitis and metritis, occurring in connection with
parturition, as well as puerperal pycemia, puerperal septicoemia, and puerperal
saprcemia, all of which the Registrar-General includes under 'puerperal fever'
were covered by that term for the purposes of notification." A Committee of
the Royal College of Physicians, to whom the question was referred, gave the
following reply:—
"That this Committee is of opinion that, with a view to the limitation of
dangerous infectious diseases, the London County Council would be acting
rightly in adopting the view that the expression ' puerperal fever,' as contained
in section 55 of the Public Health (London) Act, 1891, should be taken to
include septicoemia, pycemia, septic peritonitis, septic metritis, and other acute
septic inflammations in the pelvis occurring as the direct result of child-birth."
The Obstetrical Society of London gave a similar reply to a similar question
submitted to them by the Metropolitan Branch of the Incorporated Society of
Medical Officers of Health.