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Low cell content—protein .02 to .05 per cent. No excess of globulin.
Dextrose normal trace. Negative Wassermann and colloidal benzoin reactions.
(ii.) Acute transverse myelitis (two cases, both fatal).
Slight increase in cell content including polymorphs. Protein .15 and .08
per cent. and excess of globulin—in favour of an inflammatory lesion, and the
negative reactions contra-indicated neurosyphilis.
(iii.) Compression paraplegia (one case, fatal).
Normal fluid.
(8) Meningismus.—In six children under the age of six years, and one aged 11,
the provisional diagnosis of meningitis was corrected by examination of the cerebrospinal
fluid, which in each case showed nothing abnormal by the subsequent course.
The symptoms of meningeal irritation, described as meningismus, were attributable to
pneumonia or broncho-pneumonia, and in one case rickets with abscess of the lung—
five of the children recovered and two died—post-mortem—no evidence of meningitis.
(9) General conditions.—In four adults, aged 30 to 60 years, whose conditions
had been diagnosed respectively as due to uraemia, neurosyphilis, cerebral tumour
and myelitis, the cerebro spinal fluid proved to be normal and the reaction tests
for neurosyphilis were negative. The final diagnosis in three cases was either
neurasthenia or malingering, the conditions being purely functional as opposed
to organic disease. In one case suffering from chronic nephritis in which the cerebrospinal
fluid showed no evidence of uraemia, death occurred as the result of cellulitis
and septicaemia.
Conjunctivitis (Oupntnaimia).Slide preparations from eye cuscnarges of
new born infants sent for examination by the Council's assistant medical officers in
charge of midwives. 14 specimens examined. In two gonococci were identified, two
were reported as "suspicious," and 12 showed a variety of cocci and bacilli but
no gonococci.
(2) Vaginitis.—Out of 4 specimens of vaginal discharge, two showed the presence
of gonococci.
(3) Sputum.—4 specimens examined, three showed tubercle bacilli.
(4) Urine.—4 specimens examined for albumin and casts.
(5) Blood.—Complete counts of two adults were made :—
(i.) A school teacher (A.S.), suffering from sarcoma of the lymphatic glands,
which proved fatal a year later.
(ii.) Miss W. slight degree of anaemia.
Miscellaneous
examinations.
During 1926, in response to requests from borough medical officers of health
and general practitioners and to assist by consultation or lumbar puncture in the
diagnosis of such notifiable diseases as encephalitis, poliomyelitis and cerebro-spinal
meningitis, visits were paid by Dr. J. A. H. Brincker or Dr. J. G. Forbes to 22 private
patients in the following boroughs : Kensington (6), Westminster (3), Islington (3),
Woolwich (2), Hampstead, Marylebone, Hammersmith, Southwark, Poplar and
Bethnal Green (one in each borough), and two cases were seen in consultation with
medical officers of the Ministry of Health.
1. Encephalitis lethargica was suspected or provisionally diagnosed in eleven
patients (eight female and three male), nine being adults, aged 15 to 63 years, and an
infant of one year.
At consultation (1) two were regarded as suffering from post-encephalitic
sequelae with moral or mental deterioration; (2) five were diagnosed as probable
encephalitis but, on removal to hospital, the subsequent course of two of these
showed their conditions to be due to cerebral tumour in one and acute endocarditis
in the other. In the three other cases, recovery followed and no sequelae have
developed and their condition, though at the time of consultation suggestive of an
attack of encephalitis, remains open to doubt. In four cases the temporary
diagnosis of encephalitis was definitely rejected, and their state was recognised as due
14172 d 2
Consultation
visits.