450 The Antitoxic Serum Treatment of Diphtheria. [Feb. 8, 



damage already done. This damage may be done at a very early 

 stage of the disease, and if the nerves or the muscles are attacked 

 before the antitoxine is injected, then we must expect to find degene- 

 rations and evidence of these degenerations in the various forms of 

 post-diphtheritic paralysis ; but of this we may be sure, the sooner 

 the poison is antagonised the less will be the risk of permanent 

 damage to the tissues. It is for this reason, I believe, that the 

 antitoxic serum treatment of diphtheria has been so much more 

 successful than the antitoxic serum treatment of tetanus. 



The hope of success in the serum treatment of diphtheria depends 

 upon the early application of the remedy. One word of warning. 

 It should not be accepted that this agent can reduce the cure of 

 diphtheria to a mere process of injection. Everything must be done 

 to improve the conditions under which the patients are treated, to 

 maintain their strength, to give them fresh air, cleanly surroundings 

 and good general hygienic conditions. It will be found withal that 

 a certain number of deaths from rapid poisoning will take place, 

 while a number of others will succumb in the later stages of the 

 disease. This serum can no more act as a specific in every case than 

 can quinine cure every case of malaria; but if properly used, we 

 believe it will reduce the mortality in a very marked degree, and if 

 at the same time those practical sanitary reforms and improvements 

 for which our country is so justly renowned are carried out, we may 

 expect that diphtheria as a scourge may gradually die out from our 

 midst. As Dr. Seaton pointed out at Buda-Pesth, we have done 

 more in this country to improve the conditions associated with most 

 specific infective diseases than any other nation in the world. If, 

 now, we can graft on to our system what is best in Behring's treat- 

 ment, I am convinced that we shall soon have diphtheria statistics 

 which will compare very favourably with any that have yet been 

 presented. The antitoxic serum treatment is only one of our lines 

 of defence against this disease ; but so much progress has already 

 been made along this line, that within a few years, or even months, 

 we may fairly anticipate the announcement of still greater advances 

 and successes. 



[G. S. W.] 



