The Anti-Toxine Treatment of Diphtheria.

Star (Christchurch), Issue 5271, 30 May 1895, Page 3

The Anti-Toxine Treatment of Diphtheria.

(Dr Hb« in the New York Forum,

The mortality of diphtheria in Paris in 3900 hospital cases treated during the four years preceding the introduction of antitoxine was 52 per cent. Of the first 300 hospital cases of true diphtheria treated with anti-toxine the mortality was but 26 per cent. There are included in these 300 only casos in which the diphtheria bacillus was found. The later reports from Paris are even more encouraging. In 231 additional cases the mortality was but 14£ per cent, showing that, with a better understanding of the use of the anti-toxine and greater skill in preparing it, the results have been steadily improving. The striking and immediate fall in the mortality in hospitals for diphtheria from 40 or 50 per cent to from 10 to 26 per cent, as in the reports given, is too marked to be accidental, especially when it has been noted in all parts of the world where the treatment has been tried. The evidence seems sufficient to establish the fact that in a child previously healthy, uncomplicated diphtheria may be cured in nearly every instance when injections are made upon the first or second day of the disease, excepting only those cases in which; the disease begins in the larynx (membranous croup). In these latter the present mortality (about 70 per cent) is likely to be very much reduced ; how much it iB now impossible to say. The effects of the serum injection are less striking here because death often results from the local disease rather than from constitutional infection. There are many cases of diphtheria in which a fatal result is not so much due to the infection of the diphtheria bacillus as to the associated infection with other germs. The products of ; the latter are in no way neutralised by anti-toxine treatment. These germs are the moat common cause of the bronchopneumonia which is so freqrient and so fatal a complication of diphtheria. In these caseß of " mixed infection " so good results are not to be expected as in the simple caseH. When the injections are made late in the disease, the benefit which results will depend upon the degree of general poisoning which has already taken place, for the patient may have already absorbed a sufficient amount of poison to cause death. i