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a certain number the patients being moribund at the time of
their arrival and beyond the reach of any treatment, no antitoxin
was given. No change took place during the year in
local treatment of the cases, and there was no new factor in
the treatment other than the injection of antitoxin. The
report went on to say that it must be clearly understood that,
with exceptions pointed out, it had been the practice at each
of the hospitals to administer serum to those cases only in
which the symptoms on admission were sufficiently pronounced
to give rise to anxiety, the mild cases not receiving any. 61.8
per cent. of the admissions were treated with antitoxin. No
less than 46.4 per cent. of the antitoxin cases were under five
years of age, against 32.5 per cent. in the non-antitoxin group,
and only 16.1 per cent. in the former class were over ten years
of age, against 33.8 per cent. in the latter. The high fatality
of diphtheria in the earlier years of life is notorious. It was
obvious, therefore, that to compare the mortality of those
treated with antitoxin with that of those which during the
same period were not so treated would be to institute a comparison
between the severe cases and those of which a large
proportion were mild. That would clearly be misleading.
The only method by which an accurate estimate could be
obtained as to the merits of any particular form of treatment
was by comparing a series of cases in which the remedy had
been employed with another series not so treated, but which
were similar, as far as could be, in other respects. That in the
present instance, was impossible; but having regard to the fact
that 61.8 per cent. of the 1895 cases were treated with serum,
an approximately accurate comparison could be drawn by contrasting
all cases of diphtheria completed during 1894. For
that purpose a number of tables were given, showing that of
3,042 patients of all ages treated during 1894, 902 died—a
mortality of 29.6 per cent.; whereas, of 3,529 cases treated
during 1895, 796 died—a mortality of 22.5 per cent.; the difference
in percentage between the two rates being therefore 7.1
That, assuming that the former rate would otherwise have
been maintained, represented a saving of 250 lives during the
past year. In tables which showed the cases exclusively dealt