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72
The average dose of antitoxin administered was 34,000 units,
and seven patients received doses of more than 100,000 units.
Intravenous injection was resorted to in five cases. Severe complications,
including pharyngeal paralysis and late cardiac failure
occurred in ten patients, recovery taking place in all cases. The
average duration of treatment was 42 days, the maximum being
77 days. Unusually severe serum reactions occurred in many
cases, and the attention of the manufacturers was drawn to this
matter.

Scarlet Fever.
During the year, 336 patients were admitted, compared with
320 during 1936. Thirty-three patients remained under treatment
at the end of the year. The type of disease continues to be
mild, but several severe cases with high temperature and marked
faucial inflammation occurred. The wide use of anti-scarlatinal
serum was continued as in former years, and has more than
justified the extra cost entailed. It has been abundantly proved
that discharge from hospital as early as is consistent with a
satisfactory clinical condition is advantageous both from the point
of view of the patient and of the hospital administration, and the
use of serum helps to bring this about in a high percentage of
cases. Four weeks is now regarded as being the optimum period
of isolation in uncomplicated cases.
The use of prontosil in the acute stages of scarlet fever has
not justified the hopes of its early advocates and, at present, there
appears to be no substitute for serum in bringing about an early
subsidence of the disease. Prontosil has, however, been used
with great success in the treatment of complications, particularly
in the later weeks of the disease.