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I drew attention in the report for 1895 to the reduction in the fatality of
the cases treated in Hospital which was co-incident with the use of Anti-toxic
Serum, the case mortality having fallen from an average of 31.5 percent,
during the two previous years to 17 per cent., while the fatality of the cases
treated at home remained practically the same, i.e., over 30 per cent. This
year it will be seen that the fatality of Hospital cases has risen to 23.5 per
cent., but it is still considerably below what it was prior to the introduction
of Anti-toxin, while the fatality of cases treated at home has fallen to below
20 per cent. Anti-toxin has, however, been used to a much greater extent
in private practice, than was the case in 1895.
It will be noticed too that the proportion of adults, in whom the disease
is much less fatal than in Children, is larger among those treated at home
than among those removed to Hospitals.
HOSPITAL ACCOMMODATION.
The accommodation provided at the Hospitals of the Metropolitan
Asylums Board for patients suffering from Diphtheria was at times during
the year insufficient, and in several instances patients could not be promptly
removed. In those cases the Board sent a letter stating that the patient could
not be admitted, and with the letter, a warrant entitling the Medical Attendant
to receive from the Board a supply of "Anti-toxin." But it would be certainly
advisable, as Diphtheria is a much more fatal disease than Scarlet Fever, for
the Managers to provide more accommodation for patients suffering from
Diphtheria, even if, by so doing, they would have to reduce the number of
beds at their disposal for cases of Scarlet Fever, as delay in the removal of
those suffering from the former disease, especially when surgical interference
is needed, deprives them of what little chance there may be of recovery,
besides increasing the risk of the spread of the more deadly disease. The
Vestry wrote to the Managers and strongly urged them to adopt this course,
but up to the present time they have not done so.