London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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treatment of chronic encephalitis, with a view to limiting the progression of the
chronic infection, has again proved unsatisfactory, and that, although, amongst
other forms of treatment, many cases were given injections of colloidal sulphur, no
definite limitation of the progression has been produced.
The symptomatic treatment of Parkinsonism in general has been continued by
giving stramonium, in some cases, in very large doses. It has been observed that
effective doses of stramonium for Parkinsonism retain their beneficial effect for
long periods, and in many cases without any deleterious effect on the patient; but,
in one or two cases lately where the patient has suddenly retrogressed under this
treatment, it has been considered that the continued administration of stramonium
for many years may ultimately produce a deleterious effect.
No definite progress has been made in the treatment of the cases of behaviour
disorder, and, as stated in previous annual reports, bulbocapnine continues to be
the only drug of any practical value for the subduing of outbursts of misbehaviour
amongst the patients.
Infectious disease following tonsillectomy.
Reference has been made in previous annual reports to cases of infectious
disease following tonsillectomy.
Four such cases of scarlet fever were admitted to the South-Eastern hospital
during the year. Reference to cases admitted to the North-Eastern hospital is made
in the report of the medical superintendent of that hospital (Dr. Harries) which
appears below.
Type of
disease, use
of serum and
duration of
stay of
Eatients in
Scarlet fever.
The medical superintendent of the North-Eastern hospital (Dr. Harries) has
reported as follows :—
There occurred only 4 deaths from scarlet fever, from which it may be inferred that the
type of the disease continued to be very mild : really toxic cases were rarely seen and cases of
septic type were very few in number.
As in recent years, the majority of patients were treated with anti-streptococcal serum
(Belmont). Usually a dose of 10 c.c. was found to be sufficient; a few patients received 20 c.c.,
and in rare instances 30 c.c. or more.
The practice of adding a prophylactic dose of diphtheria antitoxin to the scarlet fever
antitoxin was continued, and was justified by the low incidence of diphtheritic rhinitis in the
scarlet fever wards.
An analysis has been made of 1,089 consecutive completed cases of scarlet fever under
treatment during the year, the diagnosis having been confirmed in every instance. Of this
series, which falls somewhat short of the whole number under treatment during the year, but
which is quite unselected, 1,000 patients were treated with anti-streptococcal serum.
Eighty-nine received no serum either because the attack was so mild and indefinite on
admission that further investigation, e.g., Dick or Schultz-Charlton tests and plating of faucial
swabbings for the haemolytic streptococcus, was necessary in order to confirm the diagnosis, or
because they were admitted in the stage of desquamation when the injection of serum would be
useless. The two series differ numerically and clinically so greatly that no statistical comparison
is attempted.

(A) Non-serum Series.

Otitis media.Adenitis.Albuminuria.Arthritis.
Early cases (68)4414
Late cases (21)1

(B) Serum Series.

(i) Age distribution.—The following table shows the age distribution of 1,000 consecutive cases treated with scarlet fever antitoxin :—

0—5 years38138.1
Over 1521321.3