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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54
Other organisms (i.e., staph, albus, non-hsem. strep., strep, viridans, diphtheroids,
B. proteus, B. subtilis, pneumococcus) were present in 36 cases.
Normal 16
Instrumental 11
Abortions 9
Sterile in 23 cases.
Normal 17
Instrumental 2
Abortions 4

The complications in 165 cases of puerperal sepsis are set out below:—

Delivery.Perineal and vaginal sepsin.Pelvic abscess.Pelvic cellulitis.Pelvic peritonitis.Septicemia.General peritonitis.Septic endo and perimetritis.Thrombosis.Pyelitis.Cystitis.Bacilluria.Severe jinipmia.
Femoral.Pelvic.
Normal6159553845467
Instrumental1122521128227
Abortion-121111-3-15
Total174915874114166919

Septic erosion of cervix 3 Lobar pneumonia 1
Cellulitis of calf 3 Septic infarct lung 1
Cellulitis of arm 2 Empyema 2
Abscess buttock 1 Otitis media 2
Furunculosis 1 Herpes facialis 1
Paronychia 2 Tonsillitis 3
Acute mastitis— Acute nasopharyngitis 5
Normal 7 Cerebral embolism 1
Instrumental 2 Toxic dermatitis 1
— 9 Belladonna dermatitis 1
Suppurative parotitis 1 Pericarditis 1
Infective arthritis 5 Mania 3
Pleurisy 2 Entero-colitis 1
Bronchitis 5 Jaundice 1
Bronchopneumonia 1
The following associated diseases were present on admission: asthma, pernicious
anaemia, Grave's disease, hydatid cyst of liver, trigeminal neuralgia, chronic
nephritis and hypertension, rheumatic endocarditis, syphilis (3), gonorrhoea (2).
The value of bladder lavage in B. coli infections of the urinary tract has been
under investigation during the past year. Encouraging results have been obtained
and we think the treatment has some value in reducing the signs and symptoms of
urinary infections, although in some cases bacilluria is apt to persist.
The following case is presented in detail as showing features of unusual interest:—
Primipara, aged 24 years. Normal delivery, 11 hours, labour 1° tear. Normal puerperium
except for complaining of stiffness in hips and difficulty in walking, which caused pain in pubis.
Discharged from nursing home on 14th day. Stayed in bed at home on account of pain.
Admitted North-Western hospital 17th day of puerperium. T. 103°, swelling and acute
tenderness over pubis. Uterus well involuted, os closed, mucoid discharge only. Vaginal and
urine culture B. coli. X-ray" destruction and wide separation of symphysis pubis." 21st day,
incision and drainage of large abscess cavity extending from both sides of vulva up to symphysis.
Culture pus B. coli, diphtheroids and staph. By 57th day incisions had closed, all swelling and
pain subsided and temperature normal for two weeks. Fitted with canvas belt. 72nd day,
X-ray showed that subluxation was reduced. Up on 80th day and remained normal.