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practitioner should have the means of availing himself of this. Diphtheria
is now such a scourge and the cost which the sickness entails
upon the community amounts to such a heavy burden, that no
reasonable outlay in measures that will check its origin and spread
can be regarded as aught but the truest economy.
Ample time has now been afforded for testing the efficacy of
“Antitoxine" in the treatment of Diphtheria, and the opportunities
have been all too frequent during the past 6 or 7 years. Good
reports upon its employment come from all quarters of the globe,
and the very few contrary statements which have come to hand have
either been based upon inadequate trial or improper employment of
the serum. The remedy is too generally used as a "dernier resort"
after the patient is moribund or requires tracheotomy, and even then
it is notorious how rapidly the distressing symptoms, as a rule,
melt away. It is thought by some that although it does such a
great deal of good during the acute attack, it does not diminish, even
if it does not increase, the subsequent tendency to fatal heart failure.
I know of no convincing statistics in support of this point, but
it is conceivable that if antitoxine is the means of bringing a patient
over the acute attack, it may appear to increase the number of
deaths from subsequent heart failure from the circumstance that it
enables many to reach the dangerous period following the acute
attack, who otherwise would have died beforehand.
The Medical Superintendents of the Hospitals of the Metropolitan
Asylums' Board have contrasted the mortality among the
Diphtheria patients admitted—where antitoxin was not used, and
where it was—during the year 1896, and the comparison has been
extended to the mortality which obtained in the year immediately
preceding the introduction of the antitoxin into those Hospitals.
There figures are in harmony with the general experience that the
death-rate among Diphtheria patients has been reduced since the
introduction of the remedy, and the conclusion arrived at, on
statistical and clinical grounds,is very favourabe to the value of the
remedy in cutting short the attack and in reducing the severity of
the symptoms.