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what retarding convalescence, and may, in cases of great
weakness threatening heart failure, prejudice the patient's
prospect of recovery. Abscess at the site of the injection,
despite the care exercised, occurred in 52 cases, or 2.3 per
cent. of total cases. "Considering the large numbers of
injections (5,086) and the septic element which is present in
so large a proportion of the severe attacks," it cannot be said
that the number of abscesses was excessive, but the percentage of such cases differed widely at the different
hospitals.
The serum used during the year 1895, was supplied
in the first eight months by the British Institute of
Preventive Medicine, and in the last four months from the
laboratories of the Royal Colleges of Physicians and Surgeons.
The dosage of serum is regulated according to the severity of
the case rather than by the age or weight of the patient. It
is stated that at the three hospitals at which an improvement
in the death-rate of more than the mean (7.1 per cent.) was
observed, the proportion of cases treated with antitoxin, and
the average amount of serum injected, were above the mean
at the remaining hospitals.
The clinical effects observed to follow the administration
of antitoxin, in cases brought under treatment at a reasonably early date, were:—(1) A diminution of the throat
swelling and consequent distress. (2) A lessening, if not an
entire cessation, of the irritating and offensive discharge from
the nose. (3) A limitation of the extention of membrane.
(4) An earlier separation of the exudation of membrane. (5)
A limitation and earlier separation of membrane in laryngeal
cases. (6) An improvement in the general condition and
aspect of the patients. (7) A prolongation of life in cases
which terminate fatally, to an extent not obtained with
former methods of treatment.