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14
The abstract of Replies of the Medical Superintendents of the Board's fever
hospitals to the inquiries of the sub-committee as to the precautions taken with the
patients before discharge, appended to their report, shews that a very careful examination
is made in each case, and everything necessary is done, and all possible precautions
taken, to ensure that the patients are free from infection before they leave
hospital. As to the measures adopted and the precautions taken by the Vestry's
officers with regard to the disinfection of infected premises, every effort is made to
secure their efficiency.
ANTI-TOXIC SERUM IN THE TREATMENT OF DIPHTHERIA.
A Report has recently been presented to the managers of the Metropolitan
Asylums Board by the Board's Medical Superintendents, on the use of Anti-toxic
Serum in the treatment of diphtheria cases in their hospitals during the year 1895.
It deals very impartially and exhaustively with the subject, and the results of the
observations made by the Board's Medical Officers are favourable to the use of
Anti-toxic Serum.
The Report shows that whereas in 1894, the percentage mortality of diphtheria
cases treated in the hospitals of the Board, was 29.6, in 1895 when Anti-toxin was
used it was 22.5, a difference of 7.l; the percentage mortality after the operation of
tracheotomy in 1894 was 70.4, in 1895 (Anti-toxin year) it was 49.3; also the number
of laryngeal cases of diphtheria requiring the operation of tracheotomy in 1894 was
equal to a percentage of 56.0, whereas in 1895 this percentage was reduced to 46.8.
The results of the observations made are thus summarised:—
(i) A great reduction in the mortality of cases brought under treatment on
the first and second days of illness.
(ii) The lowering of the combined general mortality to a point below that of
any former year.
(iii) The still more remarkable reduction in the mortality of the laryngeal
cases.
(iv) The uniform improvement in the results of tracheotomy at each separate
hospital.
(V) The beneficial effect produced on the clinical course of the disease.
Stress is laid upon the time when the treatment is commenced, to quote the
words of the report "to obtain the largest measure of success with Anti-toxin, it is
essential that the patient be brought under its influence at a comparatively early
date—if possible not later than the second day of the disease."
The effects which were observed clinically to follow the use of Anti-toxin where
the cases came under treatment at a reasonably early date are given as follows:—
(i) A diminution of the faucial swelling and consequent distress.
(ii) A lessening, if not an entire cessation of the irritating and offensive
discharge from the nose.