PEACTICE OF MEDICINE AND HYGIENE 



Thirty years ago there were surgeons who 

 were occupied performing tracheotomy upon 

 choking children more than with any other 

 branch of surgery. Then intubation was in- 

 vented to take its place ; but it was followed so 

 closely by the discovery of diphtheria antitoxin 

 that it has had little opportunity to demon- 

 strate what it could do. Now these operations 

 are rarely required. In the city of Baltimore 

 in 1894 the mortality of diphtheria was 74 per 

 cent.; in 1895, 71 per cent.; in 1896, 51 per 

 cent. In 1897 antitoxin was introduced. In 

 1898 the mortality was 5 per cent.; in 1899 it 

 was 4.6 per cent. In the city of New York in 

 1893, the year before antitoxin was introduced, 

 there were 7000 cases of diphtheria with 2600 

 deaths, a mortality of 36 per cent. During the 

 same year the mortality among children treated 

 for diphtheria in the best hospitals was 34 per 

 cent. In 1898 the mortality was reduced to 12 

 per cent.; and in 1906 it was 9 per cent. The 

 statistics in New York City show that since 

 1902, among the cases treated with antitoxin 

 furnished by the State Department of Health, 

 the total mortality has been 5.9 per cent. Among 

 those cases which received it on the first day of 

 the disease the total mortality was only 1.5 per 



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