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"It is fortunately a remedy that is not required every day by
practitioners, and unfortunately one that does not ' keep well.'* Consequently,
if stored by them and not used quickly, it would deteriorate and
might fail in its effect at the critical moment—to the sacrifice of a life.
"I am entirely in sympathy with Dr. Glover's suggestion, because
practitioners find it difficult to get the serum at a moment's notice
without sending far afield, and at a time, too, when moments are precious.
"It is an entirely new departure which I advocate, but one which
I trust will be practised shortly by every public health authority in the
country, whose duties and responsibilities do not begin and end with that
which is written in Acts of Parliament."
The above report, it will be seen, deals only with the treatment of Diphtheria
with antitoxin when such treatment was in its infancy. Since then twelve
years have passed, and it has now reached its maturity. Nevertheless, in
those days I had full confidence in its efficacy, and did not hesitate to advise
that a supply of the serum should be available in times of emergency for the
medical profession.
Now that the curative powers of antitoxin have been thoroughly tested,
it will be well to consider what it has effected since 1897; and happily very
full figures are available, thanks chiefly to the Metropolitan Asylums Board
and to some other institutions which have kept records of their work.
In 1897 the mortality in the Hospitals of the Metropolitan Asylums Board
fell from the average of 30.4 per cent. which obtained in the four years 1890-93
to 24'3 per cent. In 1898 it was 17.5 per cent.; in 1899, 15.4; in 1900, 12.9;
in 1901, 12.6; in 1902, 10.2; in 1904, 10.9; in 1905, 9.0; in 1906, 10 4; in
1907, 10 4; in 1908, 10.9, and in 1909, 9.7 per cent. Thus we see that there
has been practically a steady fall in each year. The figures in the later years
indicate that the mortality has now reached a fairly uniform percentage. Let
us see what this means. Vide Chart B.
In 1908, 5,247 cases of Diphtheria were treated with antitoxin in the
Metropolitan Asylums Board's Hospitals, and of these 507 died. Now if
this serum had not been used, it is fair to infer that the fatality would have
been the same as in the pre-antitoxin years, namely, 30.4 per cent., so that it
may safely be inferred that instead of 507 deaths, the actual number which
occurred, there would have been 1,595 deaths; consequently the saving of
1,090 lives may fairly be ascribed to the administration of the serum.
When we examine the records of the severest cases of Diphtheria, that is
to say those in which it became necessary to resort to tracheotomy so as
to give the patients even a remote chance of living, we find the figures equally
convincing, for we discover that the fatality has been reduced from an average of
* Antitoxin serum is now made which is guaranteed to keep for two years.