IOWA ACADEMY OP SCIENCES. 203 



should be used; on the third day 3,000 units and on the fourth 

 day 4,000 units. If the case seems to be dangerous when first 

 seen by the physician 2,000 or 3,000 units should be given at 

 once, even though it is said to be only the first day of the 

 attack. If the patient does not yield to the treatment very 

 satisfactorily by an improved condition of all the symptoms 

 within thirty-six hours a second 2,000 units should be given. 



This serum is now so well adapted for this purpose that it 

 can be administered without hesitation to small children in 

 large doses and can be repeated with impunity when heroic 

 doses are indicated. When this remedy does not work like a 

 charm in this disease it is probable that the patient does not 

 have diphtheria and is not suffering from toxin poison or else 

 that the dose already given was not large enough to neutralize 

 the poison. 



Local applications should frequently be made to the throat, 

 and nerve tonics given often at first and continued more mod- 

 erately until convalescence is completed. 



Quarantine rules and regulations are made by boards of 

 health, but in diphtheria every case should remain in quaran- 

 tine until repeated examinations demonstrate that all the Klebs- 

 Loeffl-er bacilli have certainly disappeared from the throat. 



The best means of disinfection is by fire. Thus, everything 

 which has been exposed to the germs of this disease should be 

 destroyed unless too valuable to be lost. The next method of 

 disinfection is by boiling all articles of clothing which will not 

 be damaged by this process. The best means of disinfecting 

 letters written by patients and other persons in quarantine to 

 be mailed is by sterilizing them with dry heat in an oven. 

 Large ovens are sometimes used, furnished wholly with dry 

 heat or partially with dry heat and partially with live steam, 

 for sterilizing mattresses, pillows and bedding. 



The two germicides most commonly in use for disinfecting 

 dishes and various other articles in the sick room are solutions 

 of carbolic acid and of bichloride of mercury. The latter is 

 more desirable because it is without odor. It is inexpensive; 

 can be used freely to soak bedding and wearing apparel in, 

 also to use in washing ceilings, walls and floors. 



Formaldehyde gas is par excellence the thing to use in dis- 

 infecting valuable garments which would be damaged by wash- 

 ing, or by being roasted in an oven, or by being fumigated with 

 sulphur. Tablets in convenient form and a stove in which to 



