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in closes between 24,000 and 100,000 units. The combined use
of intra-venous with intramuscular injection seems to be the best
means of ensuring absorption in the system. No ill-effects followed
its use.
In markedly toxic cases the intra-venous injection of 20 c.c. 50%
sterile glucose solution, combined with glucose in large quantities
orally appeared to be most satisfactory in causing a general improvement.
Coramine in doses of 0.5 c.c. to 1.7 c.c. intra-muscularly as a
heart stimulant was also satisfactory; it was also given alternately
with intra-muscular injections of 1 c.c. camphor in oil. For toxic
cases with marked cardiac weakness adrenalin chloride 1-1,000 solution
subcutaneously in doses of 0.5 c.c. to 1 c.c. were also beneficial.
The low incidence of true clinical Diphtheria is probably a
phase in the cyclic behaviour of the disease, but possibly the steady
increase in the number of children immunised is also a factor.
For a town of the size of Croydon, surrounded by thickly populated
districts, the incidence of both Scarlet Fever and Diphtheria
during 1936 has been satisfactorily low. This has necessitated a
constant strict vigilance.
Typhoid and Para-typhoid Cases.
Eleven cases of Typhoid Fever were admitted; in nine the
diagnosis was confirmed, the other two being cases of simple
enteritis and streptococcal septicaemia respectively. Four deaths
were recorded, all due to toxaemia with rapid heart failure. Four
cases of para-typhoid fever were admitted. In all, the diagnosis
was confirmed. Two of the cases were directly connected with the
Bournemouth and Poole oubbrak. Both these cases were fatal.
Puerperal Fever.
Fourteen cases were admitted with a diagnosis of Puerperal
Fever and nine with a diagnosis of Puerperal Pyrexia. Of the
fourteen cases of Puerperal Fever in seven the diagnosis was confirmed.
The other seven cases were as follows:—
Sent in as Puerperal Fever but really Pyelitis 6
Mastitis 1
The cases of Puerperal Fever were of average severity and tow
deaths occurred amongst them, one being complicated by Scarlet
Fever. Towards the end of the year Prontosil Album was tried