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which this treatment was used 7 were very severe cases, and
the treatment seems to have been of great value. Death
resulted in one case from Nephritis, but in this case the
kidney trouble had begun before the injection of antitoxin,
and the diphtheria itself appeared to have been influenced
for the better by the treatment. In all the other cases
recovery took place, and in the one mild case the diphtheric
membrane cleared off in 24 hours. In no case was any bad
effect observed from the injection.
I have before me the combined report of the Medical
Superintendents of six of the Hospitals of the Metropolitan
Asylums Board, " upon the use of antitoxin serum in the
treatment of diphtheria in the hospitals of the Board during
the year 1895."
No fewer than 2,182 cases have been treated by injection
of antitoxin serum. The results of the treatment are
grouped in a number of Tables, 71 in number. The results,
however, are shortly as follows :—
"Whilst of 3,042 patients of all ages treated without
antitoxin in 1894, 902 died; of 3,529 cases treated in 1895
only 796 died, a mortality of 22.5 per cent. in 1895 against
a mortality of 29.6 per cent. in 1894. The serum injection
was used only in severe cases ; but the general average of
severity of the disease among the cases was about the same
in both years. The difference in mortality was especially
noticed in cases under 5 years of age, there being a difference
in favour of 1895 of 13.2 per cent. As diphtheria is exceedingly
fatal to young children, this improvement is all the
more satisfactory. The earlier the treatment was begun the
better the results, and in the hospitals, where the doses were
large, and the antitoxin treatment had been most often
used, the mortality was smallest.
In cases in which tracheotomy was necessary, recovery
occurred in 50 percent, more of the cases in which antitoxin
was used, than in previous years without the use of antitoxin.
The conclusion arrived at, therefore, is distinctly in
favour of the value of antitoxin in the treatment of