View report page

55
H.G., male, aged 57. Ward 8 (N). Accountant. Onset about 10th February. When first
seen by doctor, nine days before death, patient was very lethargic, gradually becoming stuporose;
could be roused for food, &c.; wasting; temperature 101°-102°; incontinence of urine; no headache;
thirst; difficulty in swallowing. Admitted to Nursing Home 19th February. Temperature
100o-102°, with morning remissions; lethargy and stupor; temporary partial ptosis of left eye;
paralysis of sphincter ani and atony of bladder; menially only partially receptive, and mechanical;
tremor present and mild delirium towards the end; inclined to dysarthria. Lumbar puncture
on 23rd February—C.s. fluid sterile. Died 26th February and notified same day. No post-mortem
examination recorded.
T.M., male, aged 65. Ward 8 (L). Porter at dining room. Onset 13th March. Fell and
cut his head on that day, and was unconscious; 14th—still unconscious, weakness of right arm;
15th—speech muddled, depressed; 17th—went to work, gait tottering, tired; 19th—loss of
memory, rhythmic movements of right arm and leg; 20th—increasing lethargy, doctor called in.
Admitted to Royal Free Hospital, 21st March. Temperature 99°-99.4°; face expressionless;
limbs very rigid and arms flexed; lethargy extreme at first, but answered when roused, gradually
improved; ptosis for one week; no squint; incontinence of urine and fæces; speech indistinct
at times. Lumbar puncture on 24th March— C.s. fluid blood-stained on withdrawal but seemed
otherwise clear. Wassermann reaction negative. Notified 3rd April. Good recovery, and discharged
12th May. On 19th August—Considerable weakness; headaches; easily fatigued;
memory impaired but improving; depressed and emotional; speech slow and rather halting;
some weakness of left arm and leg; slight left ptosis.
J. L., male, aged 63. A broker, resident in Scotland, and staying at a hotel in St. Pancras
temporarily. Known to be well until 1 p.m. on 7th September, and at 10 p.m. reeled into the hotel
speechless, ataxic and covered with road dust, and fell on the stairs. His condition could easily
be mistaken for alcoholism (which was not present). When seen that night by the doctor he was
semi-comatose and abusive when roused; incontinence of urine and fæces; no vomiting; about
1/10 albumen in urine. This condition persisted for four days; restless at night but slept by day;
temperature sometimes 100.6° for three days, and afterwards normal; no paralysis, but slight
twitching of hands and temporary strabismus occasionally; severe frontal headache until lumbar
puncture; albumen cleared up entirely by 14th September (after venesection); Babinsky reaction
in left foot only. Lumbar puncture on 15th September, followed by marked improvement; C.s.
fluid under considerable pressure, clear, no bacteria seen, sterile, total cells (all small mononuclears)
10 per c.mm., globulin increase test positive (globulin detectable in a dilution of 1 in 3). Dr. J. S.
Collier saw the patient in consultation on 15th September and confirmed the diagnosis. Patient
removed to Nursing Home on 16th September and notified same day. Went home to Scotland
on 28th September recovered physically but not yet mentally: no further history available.
MALARIA.
18 cases of malaria were notified in 1921, and 1 death was recorded. In all cases
the infection had been contracted abroad. All the cases were visited and such assistance was
given as was necessary.
DYSENTERY.
One case of dysentery was notified in 1921. The case was fatal, the diagnosis being
made following the post-mortem examination, which was ordered by the coroner on account
of the sudden death of the deceased. The origin of the infection, which was thought to be
probably bacillary, was not traced.
PNEUMONIA.
During the year there were 242 cases of acute primary pneumonia notified, and 99 of
acute influenzal pneumonia. There is reason to believe that the notification of these diseases
is far from complete. This is partly due to uncertainty of definition.
During 1921 there were registered 89 deaths ascribed to broncho-pneumonia 47 to
lobar pneumonia, and 37 to pneumonia (type not stated).