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with by antitoxin during 1895, and those with all cases in 1894,
striking differences were observed in the figures giving the results
of treatment commenced upon the first and second days
of illness. In the antitoxin cases the mortality per cent. for
the first day was only 4.6 per cent., and for the second day
14.8 per cent.; whilst for 1894 the figures were 22.5 per cent.
and 27 per cent. respectively. In another table it was shown
that the combined tracheotomy mortality for all the hospitals,
which in 1894 was 70.4 per cent., had fallen to 49.4 per cent.
in 1895. That was a lower death-rate than had ever been
recorded in any single hospital of the Board for a year's consecutive
tracheotomies. In other words, rather more than 50
per cent. of children on whom the operation had been performed
had been saved since the employment of antitoxin. In one of
the hospitals no less than a fraction under 60 per cent. survived,
although the recoveries in that hospital in any former
year did not exceed 25 per cent., and in the preceding year—
viz., 1894—were as low as 10 per cent.
The medical superintendents conclude their report by the
following statement: The improved results in the diphtheria
cases treated during the year 1895, which are indicated by the
foregoing statistics and clinical observations, are—(I) a great
reduction in the mortality of cases brought under treatment on
the first and second day of illness; (2) the lowering of the
combined general mortality to a point below that of any former
year; (3) the still more remarkable reduction in the mortality
of the laryngeal cases; (4) the uniform improvement on the
results of tracheotomy at each separate hospital; (5) the
beneficial effeCt produced on the clinical course of the disease.
A consideration of the foregoing statistical tables and clinical
observations, covering a period of twelve months and embracing
a large number of cases, in our opinion sufficiently demonstrates
the value of antitoxin in the treatment of diphtheria.
It must be clearly understood, however, that to obtain the
largest measure of success with antitoxin it is essential that the
patient be brought under its influence at a comparatively early
date—if possible not later than the second day of the disease.