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105
Analysis of 7 Fatal Cases.
The cases were divided as follows:—
2 were moribund on admission, dying within one hour.
2 were hemorrhagic.
2 shewed early heart failure which was progressive.
1 shewed increasing late paralysis, the intercostal involvement
causing death.
There were 4 males and 3 females.
Five cases were admitted late between 4th day and 9th day
of disease respectively. They were all very severe cases with extensive
membrane, glandular enlargement, cyanosis and foetor.
Six of the cases had received no serum before admission, whilst 1
case only received 8,000 units.
Intra-muscular doses of serum between 24,000 units and 56,000
units were given to all cases, one case receiving 16,000 units intravenously.
Though large doses of serum are of great value in the
treatment of diphtheria when given early in the disease, in those
late cases the beneficial effect is less marked, as the patient has
already absorbed a great amount of toxin into his system, which one
cannot "fix," and is the cause of the subsequent rapid paralysis of
heart.
The total deaths amongst true diphtheria cases were 7 as compared
with 12 in 1930: the death rate was 3.1%.
Enteric Fever.
8 cases of Enteric, and Paratyphoid were admitted: 1 case was
admitted from Penge.
The following gives an analysis of these cases:—
Sent in as enteric and confirmed 2
Sent in as para-typhoid and confirmed 3
Sent in as enteric and not confirmed 1
Sent in as enteric, really dvsenteiy 1
Sent in as enteric: really simple enteritis 1
The cases were clinically of moderate severity and there were
no deaths.