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Poplar ; on the other hand, of the South Groups in every one of the Districts the
death-rates are below the average of London, the highest being Lambeth and
St. Saviours, and the lowest Woolwich, St. Olave's, Lewisham and Bermondsey.
St. Martin's in the Fields, and St. Giles in the Central Group are also high,
and so is Paddington in the Western Group.
To what extent these differences are due to schools, social conditions, and the
influence of hospital isolation it is difficult to gauge.
Anti-toxin in Diphtheria. — Recently a Seport, issued by the Metropolitan
Asylums Board, has been made by the Medical Superintendents upon the
use of anti-toxic serum in the treatment of Diphtheria in the Hospitals of the
Board during the year 1895. The experience of treatment by serum injection
extends over 2,182 cases, and the report is of a satisfactory character, the
unanimous opinion of the six Medical Superintendents being that " in anti-toxic
serum we possess a remedy of distinctly greater value in the treatment of
Diphtheria than any other with which we are acquainted."
The summaries of the effects and of the results of the treatment are so clear
and comprehensible that by quoting them in extenso the best idea of the
effects and results will be gathered.
Certain effects have been observed clinically to follow the administration
of anti-toxin in cases brought under treatment at a reasonably early date,
they are:—
(i.) A diminution of the faucial swelling and consequent distress.
(ii.) A lessening, if not an entire cessation, of the irritating and offensive
discharge from the nose.
(iii). A limitation of the extension of membrane.
(iv.) An earlier separation of the exudation.
(v.) A limitation and earlier separation of membrane in laryngeal cases.
(vi.) An improvement in the general condition and aspect of the patients.
(vii.) A prolongation of life, in cases which terminate fatally, to an
extent not obtained with former methods of treatment.
(viii.) No constant or important effect upon either the temperature or
pulse rate is attributable to anti-toxin.
The improved results in the diphtheria cases treated during the year
1895 are:—
(i.) A great reduction in the mortality of cases brought under treatment
on the first and second day of illness.
(ii.) The lowering of the combined general mortality to a point below
that of any former year.
(iii.) The still more remarkable reduction in the mortality of the
laryngeal cases.
(iv.) The uniform improvement in the results of tracheotomy at each
separate Hospital.
(v.) The beneficial effect produced on the clinical course of the disease.