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it was 29.6 per cent., a reduction of 7.1 per cent. Of
children under 5 years of age there was a reduction of
13 2 per cent., viz., from 47.4 to 34.2 per cent.
This marked reduction in the death-rate was coincident
with the use of antitoxic serum in the treatment of 2,182
of the 3,529 cases of diphtheria at the Board's Hospitals
during 1895.
The Medical Superintendents of these Hospitals have
published an elaborate and exhaustive report on the results
that have attended this treatment. Their conclusions are
thus summarised:—
" The improved results in the diphtheria cases treated during the
year 1895, which are indicated by the foregoing statistics and clinical
observations, 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.
" A consideration of the foregoing statistical tables and clinical
observations, covering a period of 12 months and embracing a large
number of cases, in our opinion sufficiently demonstrates the value
of antitoxin in the treatment of diphtheria.
" It must be clearly understood, however, that to obtain the largest
measure of success with antitoxin it is essential that the patient be
brought under its influence at a comparatively early date—if possible,
not later than the second day of the disease. From this time onwards
the chance of a successful issue will diminish in proportion to the