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General Treatment.—The greatest change in the treatment
carried out during the year lay in the introduction of the serum
treatment for scarlet fever, a report on the anticipated advantages
of which was set out in Appendix 3 of the Annual Report for 1934.
As indicatd elsewhere in this Report, the use of serum in the treatment
of all cases admitted to hospital and the isolation of these
cases for three weeks is, in my opinion, a definitely progressive
step. Not only do the complications tend to be diminished, but,
what is even more important, the danger of cross-infection appears
to be lessened, as is evidenced by the figures set out on page 72,
while the "return case" rate is not increased. The patients
certainly seem to be happier when allowed on full diet and out of
bed within ten days of admission, while the fact that no untoward
late effects are to be expected is shown by the result of the visits
paid to the homes by the Health Visitor after the patients' discharge
from hospital, and by the "clearance" examinations carried out
at the Town Hall. (It might be of interest to note here that my
colleague, Dr. Kirkhope, the Medical Officer of Health for Tottenham,
has come to the same conclusion as myself after a study of the
patients discharged to his own area.) Thus, from all aspects, the
serum treatment of scarlet fever in conjunction with the three
weeks' detention period, appears worthy of a further extended
trial in its present form. Incidentally, it has not been necessary
to use the intraperitoneal or the intravenous method of injecting
the serum, the intramuscular method having been sufficient in all
cases up to the present. Finally, the prejudice of some parents to
the early discharge of their children is being slowly overcome, very
little difficulty being now met with in this connection.
Glucose, iodine in milk, alkaline mixtures and adrenalin
injections, in addition to large doses of serum administered intravenously
and intramuscularly, are now being used in the treatment
of hypertoxic diphtherias. This combination has so far yielded
satisfactory results and is being given an extended trial.
The form of treatment adopted with regard to the remaining
diseases admitted to hospital has remained more or less unaltered,
except where newer and more concentrated brands of serum have
been used in the treatment of certain infections.
The ultra-violet and infra-red apparatus continues to serve a
valuable purpose and has been made use of as hitherto throughout
the year.
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