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72
The late administration of serum does not exert much
influence on the course of the disease. Diphtheria toxin rapidly
becomes fixed in the tissues, and when once fixed, anti-toxin has
no effect in counteracting its poisonous effects.
Only two cases received serum1 before admission. Intramuscular
and intra-venous injections of serum were given in doses
between 24,000—80,000 units, one case receiving 28,000 units
intra-venously.
The majority of the fatal cases tabulated above were admitted
after the 3rd day of disease, so that the beneficial effect of early
administration was not possible.
Intra-venous administration of serum, combined with intramuscular
injections seems the best method for ensuring rapid
absorption into the system. No ill-effects were noticed when this
was tried.
In seven cases seen late in the disease the combination of
intra-venous injection of serum with 20 c.c. sterile 50 per cent.
glucose appears to be most satisfactory, as it improves the pulse
and general condition.
Enteric Fever.
Only three cases of Enteric Fever were admitted, compared
with eight cases in 1933. In two the diagnosis was confirmed,
but one proved a case of simple enteritis.
Puerperal Fever
Twelve cases of this disease were admitted, as compared
with 13 cases during 1933. In two cases the diagnosis was not
confirmed. Of the other ten:
In two the infection was limited to uterus, vagina and
perineum;
Seven cases involved the pelvic cellular tissue, ovaries+
+tubes + pelvic veins;
One case was a general peritoneal infection with septicaemia,
which proved fatal.