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lastly by the more recent method of neutralising the poison of the
malady by the injection of the counteracting serum of an animal
immunised against the disease.
88—All these methods have been employed at the Borough
Hospital from time to time when indicated by circumstances.
89—Under the first or specific treatment a 10 percent solution
of citric acid, which possesses the property of softening diphtheritic
membrane outside the body, was administered very frequently both
locally and internally. Of the 15 cases so treated 11 recovered
and four died.
90 —A series of 15 consecutive cases were treated by local application
of glycerine of carbolic acid, combined with frequent
irrigation with boracic acid lotion. These all recovered, but the
type of the disease did not happen to be severe.
91 —In another series of 19 cases the throat was swabbed out
twice daily with a 1-500 solution of perchloride of mercury, and
the nose and pharynx frequently irrigated with boracic lotion.
All these cases were fairly severe, and of the 19 thus treated
15 recovered and four died. Of chemical remedies this seems to
me the most successful and reliable.
92—In January last the highly favourable reports of foreign
physicians upon the anti-toxin serum treatment of diphtheria
having been apparently confirmed by the experience gained in
certain English Hospitals in which it had been tried, the Committee
sanctioned its employment in the Borough Hospital,
subject to the consent of the patients' parents.
93—In order to form a conscientious opinion as to the efficacy of
this method, I thought it right to select only severe and undoubted
cases, and as far as possible to confirm the clinical diagnosis both
by bacteriological and cultural examination before commencing
the treatment.
94—Up to the end of March last eight cases, Nos. 46, 48, 49, 50,
51, and 52, Table VII., and Nos. 7 and 8, Table VIII., were treated
by injection of anti-toxin. They were all severe and undoubted
cases, and in two it was only resorted to after other treatment had