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not really diphtheritic would not be sent to hospital, nor any further
unnecessary preventive measures taken.
A great advance in the treatment of diphtheria has, during the past year,
been carried out in the hospitals of the Metropolitan Asylums Board, namely,
by the use of antitoxic serum.
The report of the Medical Superintendents of these hospitals has just
been issued. The following is their summary of the improved results in the
diphtheria cases treated during the year 1895, which are indicated by their
statistics and clinical observations :—
(I) A great reduction in the mortality of cases brought under treatment
on the first and second day 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 improvements in the results of tracheotomy at each
separate hospital.
(V.) The beneficial effect produced on the clinical course of the disease.
"Certain secondary effects not infrequently arise as a direct result of the
" injection of antitoxin in the form in which it has at present to be
" administered, and even assuming that the incidence of the normal complica"
tions of diphtheria is greater than can be accounted for by the increased
" number of recoveries, we have no hesitation in expressing the opinion that
" those drawbacks are insignificant when taken in conjunction with the
" lessened fatality which has been associated with the use of this remedy."
Similar beneficial results have been experienced on the Continent and
in New York. In the latter, the returns of deaths given for the first three
quarters of 1895 show that there has been the large reduction in the
death-rate of 43.9, as compared with the average death-rate for the
corresponding periods of the previous four years.
TYPHOID FEVER.
There was a reduction in the number of cases of typhoid or enteric fever
notified during the year of about 17 per cent., viz, from 24 to 20. During
the last six months there were 12 cases as compared with 16 for the corresponding
period of 1894,