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31
Local Government Board,
Whitehall,
2oth March, 1897.
Sir,
I am directed by the Local Government Board to advert to your
letter of the 19th January, enquiring whether, having regard to the fact, that
in the 3rd edition of " Nomenclature of Diseases recently published by the
Royal College of Physcians, 'Membranous Croup' is stated to be a synonym
for 'Laryngeal Diphtheria,' the Board considers that patients certified as
suffering from ' Membranous Croup ' without qualification, may properly be
admitted into the hospitals belonging to the Managers of the Metropolitan
Asylum District.
I am directed in reply, to inform the Managers that the Board are advised
that the term "Membranous Croup" per se is not sufficiently definite, inasmuch
as membranous inflammation of the larynx may arise from causes other than
diphtheria.
I am, Sir,
Your obedient Servant,
W. E. Knollys,
Assistant Secretary.
T. D. Mann, Esq.,
Clerk to the Managers of the
Metropolitan Asylum District,
Norfolk Street, W.C.
DIPHTHERIA ANTITOXIN.
The Report of the Medical Superintendents upon the use of antitoxic serum
in the treatment of diphtheria in the hospitals of the Metropolitan Asylums
Board during the year 1896, draws the conclusion that the improved results
in the diphtheria cases treated during the year are due to :—
(t.) A great reduction in the mortality of cases brought under treatment
on the first three days of illness.
(it.) The lowering of the combined general mortality to a point below
that of any former year.
(in.) 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.
(iv.) The beneficial effect produced on the clinical course of the disease.
Great stress is laid upon "the paramount importance of commencing the
treatment early "—if possible, not later than the second day of the disease.
The opinion is again expressed that antitoxic serum is a remedy of much
greater value in the treatment of diphtheria than any other known.