London's Pulse: Medical Officer of Health reports 1848-1972

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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London

Croydon 1937

[Report of the Medical Officer of Health for Croydon]

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83
Intra-venous and intra-muscular injections were given in
doses between 24,000 and 100,000 units. The combined use of
intra-muscular with intra-venous injections 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 per cent, sterile glucose solution, combined with glucose in
large quantities orally, appeared 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. of
camphor in oil. For toxic cases with marked cardiac weakness,
adrenalin chloride 1/1000 solution subcutaneously in doses of
5c.c. to 1 c.c. was also beneficial.
Particulars of Fatal Cases of Diphtheria.

Table: Table XI.

Table XI.

Name.Age on Admission.Condition on Admission.Subsequent Progress.Time of Death after admission.
F.S. (M)4 3/12Moribund, extreme cyanosis, sloughing membrane over whole pharynx, glands of neck † † †, foetor, toxaemia.Did not respond to treatment, dying in coma soon after admission, from rapid heart failure.l¾ hrs.
D.W. (M)2 4/12Collapsed, v. toxic. Extensive membrane over whole pharynx, bull - neck, rhinorrhœa, foetor.Did not respond to treatment, increasing heart failure, became unconscious, dying the same day.10 hrs.
D.J. (F)10/12Exudate on both tonsils, profuse rhinorrhœa.Showed signs of heart failure 1 week after admission, with persistent vomiting and "gallop" rhythm, grew steadily worse, child collapsed on 11th day.11 days.
G.C. (M)7Membrane over both tonsils with enlargement of neck glands.Heart became irregular on 5th day after admission and signs of heart failure increased. The child collapsed on the 11th day.11 days.