A Lecture ON MENINGITIS IN CHILDREN: Delivered at the London School of Clinical Medicine
Authors: G. Rankin
Journal: BMJ (1910)

There was impaired resonance with prolonged expiration at the right apex.. Diminished resonance, prolonged expiration, and moist crepitations over the greater part of the upper lobe and at the apex of the lower lobe on the left side.Tubercle bacilli were found in the sputum.She remained in the hospital (Hampstead and Northwood) until October, 1909, when she left much improved.She has not been at work since, but wrote at Christmas that she felt well and was anxious to get a situation as soon as possible.Apparent Infection during Residence in Hospital.ProbatioDer Nurse Marie M., aged 25.Examined on entry, February, 1900, and found healthy.In November, 1900, she was reported to me, having got thinner and lost weight.She was easily tired, slept badly, and suffered from headaches.I found the breath sounds harsh at the right apex, where there were some inconstant crepitant rAles.A week later crepitations were detected at both apices, and she was put off duty.A month later the signs were more definite, especially at the right apex.She remained under my care for about five years before I could certify that the mischief was completely arrested.During this time sbe spent three and six months respectively at sanatoriums, the second occasion being in consequence of activity in the left lung, the right being quiescent.For the last three years-July, 1902, to July, 1905-she was on night duty at the hospital.During the whole period she never had any expectoration.She has, since leaving the hospital, held posts at private sanatoriums, and remains well, reporting herself to me for examination at intervals when in London.Nurse M. was engaged for some months before her break- down in charge of the out-patient waiting room, and it seems possible that she became infected from the out-patients, who are not sufficiently careful in the matter of expectoration until they have been instructed in the necessary precautions.The out-patient department at Hampstead has since been closed.Rose H., aged 21.Wardmaid.Entered the hospital in October, 1902, and was then quite healthy.In April, 1905, 'she was "1 run down," had some morning cough, and on examination was found to have harsh breathing and some moist crepitations in the apex of the right lung.Examination of the sputum showed the presence of tubercle bacilli.She was taken off duty and put under treatment.She remained under treatment at Hampstead and Northwood until her death in 1908.It was found that this girl had become engaged to a patient who had tuberculous laryngitis, and who, when he left the hospital, took rooms at Hampstead.There were thus many opportunities of direct infection.Jessie W., aged 26.Probationer nurse.Entered December, 1907.Healthy.In February, 1908, she ran a splinter into the left first finger whilst rubbing a ward table.A week later the finger was swollen and brawny, and Mr. Berry laid the track of the splinter open in the Royal Free Hospital, where the condition was pronounced to be tuberculous.In October, 1908, the finger was practically well, but the nurse was very anaemic and not very strong.