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of the various strains of pneumococci require a high degree of
laboratory organisation, and these investigations would, if necessary,
have to be made in conjunction with a general hospital or
public laboratory.
Diphtheria.
During 1935, 250 patients were admitted compared with 374
during 1934. Of this number 203 were faucial, 37 were nasal,
5 laryngeal, 3 aural, 1 faucial and nasal, and ,1 aural and nasal.
Forty-eight patients remained under treatment at the end of 1934.
The disease showed a decline both in prevalence and virulence,
although many cases of considerable severity occurred. The number
of completed cases was 281. The number of deaths was
twelve, giving a mortality rate of 4.3 per cent, compared with
11.4 per cent, for 1934. An analysis of the fatal cases is as
follows:—
Five cases were haemorrhagic. In one case the patient
died on admission and the certificate was furnished by the
outside medical practitioner.
Five cases showed severe infection with the diphtheria
gravis bacillus and died within two weeks of admission.
The remaining two were cases of cardiac and respiratory
paralysis.
Eighteen other cases of severe complications occurred, but all
ended in recovery. One rather unusual case of faucial diphtheria
was complicated on admission, by marked cardiac dilatation,
cyanosis, ascitis and general oedema. The patient fortunately
responded to treatment and was transferred to a Chest Hospital
after 56 days.
The age incidence of the patients admitted was as follows:—
0 — 5 5 — 10 10—15 15 + Total
63 109 48 30 250
Scarlet Fever.
During 1935, 344 cases were admitted compared with 796 in
1934. Sixty-six patients remained under treatment at the end of