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of 5.5 per cent, in the year 1926. Eight of the fatal cases were of
the haemorrhagic type of diphtheria, two died from postdiphtheritic
paralysis of the respiratory muscles, nine died within
24 hours of admission to Hospital, whilst the remainder were
suffering from profound toxaemia on admission. The average
duration of illness, prior to admission to Hospital, in the 27 fatal
cases, was four days, and the administration of anti-diphtheritic
serum holds out little hope of recovery in cases so advanced in the
disease Towards the end of the year Diphtheria assumed a more
severe form than has occurred for many years, and the patients
exhibited diffuse foul-smelling pharyngeal deposits with marked
glandular enlargement, periglandular oedema and severe toxaemia
with the frequent supervention of vaso-motor paralysis, cardiac
dilatation and, in some cases, death in the first or second week of
the disease. In these cases bacteriological examination has revealed
the presence of diphtheria bacilli in chain formation and
the presence of streptococci, and it is proposed to deal with the
latter infection by means of inoculation with polyvalent antistreptococcus
serum, whilst the increased virulence of the diphtheria
bacilli may be met by intraperitoneal or intravenous inoculation
of anti-diphtheritic serum.
The chief complications which occurred in the cases of
Diphtheria under treatment during the year were:—
Paralysis 29
Rhinitis 25
Broncho-pneumonia 4
Cervical Adenitis 67
Myocarditis 14
Laryngitis 22
Epistaxis 19
In three cases operations were performed for acute suppurative
cervical adenitis with satisfactory results.
In some instances patients were admitted who were suffering
from some other disease in addition to Diphtheria, and the following
table gives particulars of these:—
Scarlet Fever 6
Varicella 3
Pertussis 3
Morbilli 5
Facial Paralysis 1
Mitral Disease 2
Herpes 9
Impetigo 8
Scabies 3
Tuberculosis 1