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
Willesden 1926
[Report of the Medical Officer of Health for Willesden]
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Table 52.
Showing the particular complications which arose.
| Complications. | Cases with one Complication. | Cases with two Complications. | Cases with three Complications. | Totals. |
|---|---|---|---|---|
| Adenitis | 1 | 3 | 1 | 5 |
| Rheumatism | 3 | — | — | 3 |
| Otitis Media | 5 | 1 | 1 | 7 |
| Albuminuria | 3 | — | — | 3 |
| Nephritis | — | 1 | — | 1 |
| Abscess | — | 1 | 1 | 2 |
| Totals | 12 | 6 | 3 | 21 |
All these complications can be described as mild except the nephritis, and the patient in this
instance had a moderately severe attack. All the cases of otitis media cleared up without difficulty
except one, and in this case the child had enlarged tonsils and adenoids which urgently required
excision.
Diphtheria.
368 cases were admitted, or 109 more than in the previous year. These cases may be classified
as follows —Faucial 264, faucial and nasal 34, nasal 31, bacteriological 16, laryngeal 10, faucial
and laryngeal 6, aural 3, faucial and aural 2, vaginal 1, ophthalmic 1. One case was tracheotomied
and recovered. A case on which tracheotomy was performed previous to admission to Hospital
died from a sudden severe haemorrhage from the tracheotomy wound. The prevailing type of this
disease has been of a severe character, and 27 deaths have occurred, giving a mortality rate of 7 • 7
per cent. In calculating the mortality rate, the bacteriological cases have been excluded. Several
cases were admitted to Hospital too late for anti-toxin to be of any avail.
Convalescent Diphtheria Carrier Cases.
A certain small number of Diphtheria cases harbour the diphtheria bacillus in the throat or
nose for a long time after they have recovered from the acute attack, and great difficulty is experienced
in dealing with these cases as they resist all the usual forms of treatment. If the individual has any
abnormal condition of the throat or nose, particularly enlarged tonsils and adenoids, the germs are
provided with a suitable place in which to harbour. In the great majority of convalescent carrier
cases, the diphtheria bacillus is of a virulent type, and such cases have been detained in Hospital
from six to twelve months before they were free from infection. The Council have given permission
for suitable cases of this class to have excision of the enlarged tonsils and adenoids carried out, and
5 cases have been treated in this way with the following results :—
The Council have given permission for suitable cases of this class to have excision of the enlarged tonsils and adenoids carried out, and 5 cases have been treated in this way with the following results :—
| Number of days in Hospital before operation. | Number of days in Hospital after operation. | |
|---|---|---|
| Case A | 126 | 40 |
| „ B | 122 | 16 |
| „ C | 84 | 23 |
| „ D | 84 | 18 |
| „ E | 54 | 19 |
In four of the cases the throat or nose proved to be free of diphtheria germs immediately after
the operation had been carried out, which is a very satisfactory result. The fifth case took rather
longer to clear up.
Mixed Infections.
Combined attacks occurred as follows :—
Diphtheria and Scarlet Fever 1
Diphtheria and Measles 1
Scarlet Fever and Measles 2
Scarlet Fever and Chicken Pox 2
Scarlet Fever and Whooping Cough 2
Scarlet Fever and Pulmonary Tuberculosis 1
Diphtheria and Whooping Cough 1
The case of Diphtheria and Scarlet Fever proved fatal.
62 cases admitted either as Scarlet Fever or Diphtheria proved to be suffering from Tonsillitis.