View report page

100
Analysis of 12 Fatal Cases.
The cases were divided as follows:—
2 were moribund on admission, dying within 12 hours.
2 were hæmorrhagic.
2 cases showed late heart failure.
4 cases showed early heart failure.
1 case was laryngeal, necessitating tracheotomy, and complicated
by progressive heart failure.
There were 7 males and 5 females.
All the cases except one were admitted between the 4th and
9th day of disease.
All the cases were very severe with extensive membrane,
glandular enlargement, rhinorrhœa and foetor, and did not respond
to repeated doses of anti-toxin.
The cases who developed late heart failure were also complicated
by other paralyses.
Intra-muscular doses of serum in doses between 24,000 and
100,000 units were given to all the cases. No intravenous injections
were given.
The total deaths amongst the true diphtheria cases were 12
as compared with 23 deaths in 1929. The death-rate was 2.5%.
The giving of anti-toxin as soon as cases are seen at home,
in adequate doses, would help to reduce the mortality. Waiting
for the result of a throat or nose swab before taking action is a
dangerous policy to adopt. Severe and even fatal cases of diphtheria
have been known, not very infrequently, to give negative
swab results.
144 phials of diphtheria anti-toxin were obtained by the Public
Health Department for use by medical practitioners on demand.
7 phials were issued direct to medical men; 41 were issued to the
various depots, and 14 postcards were received of phials having
been issued to doctors; 16 phials were issued to the Pathological
Laboratory and 6 to the Croydon General Hospital.
The list of depots where stocks of anti-toxin are kept for the
use of medical men on demand, and free of charge in needy cases,
is given below. In addition, at each of these depots swabs, sputum
and other outfits are kept for the purpose of taking specimens for
bacteriological examination.
The Public Health Department, Town Hall (during office hours).
The Borough Hospital, Purley Way, Croydon (any hour).