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prevalence of scarlet fever resulted in the demand on the accommodation
necessitating the opening of the Honeypot Lane Hospital. The greatest
number of cases of scarlet fever under treatment on any one day was
65, and of diphtheria 13.
As in previous years, cases of other infections had to be admitted
to the hospitals of other authorities. In all, during the year, 77 patients
were removed to other hospitals, this figure including 16 cases of puerperal
infection. Towards the end of the year on a number of occasions
difficulty was experienced in finding room for some of these patients in
outside hospitals and on two occasions a patient suffering from erysipelas
had to be treated at home because accommodation in hospitals could not
be found for them.
CLINICAL ASPECTS.
Scarlet Fever.
Admissions :
Number admitted with a diagnosis of scarlet fever 434
Number suffering from scarlet fever 422
Number in whom diagnosis not confirmed 12
Of these 12 cases, two each suffered from chicken pox, erythema,
and urticaria.
Deaths : Nil.
Treatment : Patients were given serum and prontosil as a routine, 289
receiving serum (mostly 3,000 but a few 6,000 units), and 407 receiving
prontosil. The difference in the two figures is because serum was not
given to those who did not come under treatment before the fourth day.
As there were no controls it is impossible to say that the small number of
complications and the general mildness of the attack was due to the
routine treatment adopted, but the administration of serum certainly has
the effect of reducing the temperature, while desquamation of any degree
was limited to those not receiving serum. 5 per cent. of the serumtreated
patients developed a rash, and about 2 per cent. of those treated
with prontosil developed a rash which was thought to be due to the
drug, while one patient also suffered from jaundice.
Complications : The incidence of complications this year was smaller
than usual, only 13 per cent. of patients admitted suffering (this figure
does not include those suffering from serum or prontosil rashes or from
those minor conditions such as cracks at the angle of the ear which might
retard discharge). The number of patients who suffered from adenitis
was 17, from rhinorrhcea 8, secondary attacks, whitlows or albuminuria
5 each ; four each from secondary sore throat and otorrhoea (one of these
proceeding to mastoiditis which required operative treatment) ; rheumatism,
nephritis, and cervical abscess one each. Some patients suffered
from more than one complication. In addition two patients suffered
from a second attack after their return home ; the one who had been in
•26 days developed it on the 7th day after return, and the other who
had been in 27 days had the onset 17 days after his return.
These numbers refer to those patients admitted to hospital during
the year even though they had not been discharged by the end of the
year.