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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 improvement in the results of tracheotomy
at each separate Hospital.
(v.) The beneficial effect produced on the clinical course
of the disease.
"We have had, in fact, somewhat better results to record for
1896 than we had for 1595 ; and in view of the extended
experience gained during the past year, together with the additional
facts concerning the post scarlatinal cases for 1896, we feel that
we are fully justified in the favourable opinion we expressed last
year on the value of anti-toxin in the treatment of Diphtheria.
"We would repeal what we stated last year as to the paramount
importance of commencing the treatment early—if possible,
not later than the second day of the disease. From this time
onward the chance of a successful issue will diminish in proportion
to the length of time which has elapsed before the treatment is
commenced. This though true of other methods, is of still greater
moment in the case of treatment by anti-toxin.
"We have already drawn attention to the trivial nature of the
secondary effects that not infrequently arise as a direct result of
the injection of anti-toxic serum, and we think that neither these
effects nor the increased incidence of some of the usual complications
are worthy of being considered practical deterrents when
the beneficial results of the treatment are remembered.