case. During the year Antitoxin was used in a number of cases
both for prophylactic and therapeutic purposes.
The value of Antitoxin treatment in Diphtheria is clearly
demonstrated in the returns of the Metropolitan Asylums Board.
In 1894, 3,042 patients of all ages were treated in the Board's
Hospitals without Antitoxin ; 902 died, yielding a mortality of
29.6 per cent.
In 1895 the Antitoxic serum treatment was inaugurated ;
3,529 cases of Diphtheria were treated, and 729 died, yielding a
mortality of 22.5 per cent. Hence, in the first year there was a
fall in mortality of 7.1 per cent.
But in 1901, 6,499 patients suffering from Diphtheria were
treated, with Antitoxin, in the Board's Hospitals; 817 died,
yielding a mortality of 12.5 per cent. There has, therefore,
been a fall in mortality percentage from 29.6 in 1894, without
Antitoxin, to 12.5 in 1901, with Antitoxin. In other respects
the treatment has been substantially the same.
Early administration of Antitoxin is important. Of that
there has been evidence in Finsbury alone, but such evidence is
all the more emphatic when extended over large numbers of cases
and over some period of time. At the Metropolitan Asylums
Board Brook Hospital in 1901, 723 cases of diphtheria were
treated with Antitoxin, and 78 died, yielding a mortality per
cent. of 10.79. The Antitoxin treatment was applied in each of
these cases, but in some it was possible to begin on the first day
of the disease, in others on the second, and so on. The
paramount importance of administration at the earliest possible
moment is seen in the result. The mortality percentage of the
first day cases was 0.0; of the second day, 4.1 ; of the third day,
11.9; of the fourth day, 12.4; and of the fifth and subsequent
days, 16.6. For five consecutive years there has not been a
death at this Hospital among the cases that came under treatment
on the first day of the disease.