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Belmont prophylactic was used in the remaining 16 cases. Of these 15 became negative
after the full course of five injections. The other remained strongly positive and was given
three injections of toxin (B.W.) with the production of the desired negative result.
X-ray work.
Dr. M. Mitman, senior assistant medical officer at the North-Eastern hospital,
who also acted as radiologist at the hospital, the X-ray department of which serves
all the Council's infectious hospitals except the Northern hospital, has reported
that the volume of work undertaken during the year was maintained at the usual
level, although the department was disorganised for a short period while alterations
were being made. These consisted of the replacement of the old apparatus by a modern
and more powerful plant, capable of performing the work more efficiently and with
greater ease.
The examinations most commonly undertaken—radiography of the skull and
of the chest in children—require high power apparatus capable of working at high
currents. The increased facilities provided by the new apparatus will permit
certain investigations, formerly incapable of performance, to be carried out. The
figures for the last two years are set out below :—
Year.
1933
1934
Total number of
patients examined.
233
226
Number of
films taken.
442
473
Chest
examinations.
73
82
Mastoid
examinations.
37
38
The Drinker respirator.
The medical superintendent of the North-Eastern hospital (Dr. Harries) states
that there can be no doubt that the Drinker respirator, the forthcoming provision
of which at that hospital was referred to in the last annual report, has saved the
lives, which otherwise would inevitably have been lost, of patients suffering from
post-diphtheritic diaphragmatic paralysis. The following is a brief note on the use of
the apparatus
The Drinker respirator is a mechanical device for administering artificial respiration over
long periods. It consists essentially of a warmed and lighted metal chamber into which the
trunk and limbs of the patient are introduced ; an almost airtight joint being formed by a rubber
diaphragm through which the patient's head is passed to rest upon a rubber cushion outside the
apparatus. A variable negative pressure within the chamber is maintained by means of a bellows
actuated by an electric motor. The pressure, which is read off upon a water manometer, is
adjustable by metal diaphragms at the distal end of the chamber, and the rate per minute at
which the bellows work, so creating the rhythmic alterations of atmospheric pressure within
the chamber, which assist the feeble respiratory efforts of the patient, is adjustable by means
of a dial. The best pressure and rate of respiration are ascertained by observation for the
individual patient and cautiously maintained or varied in accordance with the clinical requirements.
The apparatus, which is the first to be acquired by the Council, is stationed at the NorthEastern
hospital, and has been requisitioned from time to time by other of the infectious diseases
hospitals of the service.
The present model is to a certain extent experimental and is to be replaced shortly by another
which will incorporate improvements and modifications which experience has shown to be
desirable.
Hitherto, the Drinker respirator has been employed elsewhere in the treatment
of respiratory failure in acute anterior poliomyelitis. It was originally employed
for post-diphtheritic diaphragmatic paralysis by Dr. J. E. Gordon, formerly of
Detroit. At the North-Eastern hospital, the primary use of the apparatus has been
for the treatment of this grave complication of diphtheria, but it has also been used
to assist expansion of the lung in cases of empyema thoracis.
Of eight patients with post-diphtheritic diaphragmatic paralysis treated in the
apparatus there were five recoveries. In some of these cases pharyngeal paralysis
was co-existent, and here the electric pump intended primarily for laryngeal suction