166 THE AMERICAN BIONTHLY [May 



pro\ (.•nlin!^- outbreaks of e})i(lemics of diphtheria, which 

 in past winters had occurred in this hospital with most 

 disastrous results, 



()utof31() cases examined, 2<) atone time or another 

 showed the presence of the Klebs-f^oeffler Ixicillus. Two 

 of these had clinical diphtheria, so that out of 314 normal 

 throats and noses, 7.*) per cent contained the bacillus of 

 diphtheria. The averag^e persistence of the bacillus on 

 the mucous membrane was fifteen days; the sh(trtest 

 period one day, the long-est 103 days. The nose was the 

 principal habitat in ()5 per cent and the throat in 35 per 

 cent. The deg^ree of virulence possessed by^ the bacilli in 

 the various cases was not determined. 



Antitoxin in Diphtheria. — The American Pediatric 

 Society are about to undertake a second collective investi- 

 i^ation of antitoxin, and they now ask that records of cases 

 of diphtheria involving- the larynx, whether operated or 

 not, occurring- in the United States, be sent to the Secre- 

 tary, W. P. Northruj), M.D., 57 P>ast Seventy-ninth street, 

 New York, N. Y. 



The following- sums up the conclusions of the Society 

 based on the first investig-ation: 



Dosag-e. — For a child over two years old the dose of anti- 

 toxin should be, in all larvng-eal cases with stenosis, and 

 in edl other severe cases, 1500 to 2<H)() units for the first 

 injection, tt) l>e repeated in from eig-hteen to twenty-four 

 hours if there is no improvement; a third dose after a 

 similar interval, if necessary. I'^or severe cases in child- 

 ren under two years, and for mild cases over that ag-e, the 

 initial dose should be lOOO units, to be repeated as abo\e 

 if necessarv; a second dose is not usuallv re(]uired. 'J^he 

 dosag-e should always be estimated in antitoxin units, and 

 not of the amount of serum. 



Quality of Antitoxin. -The most concentrated strength 

 of an absolutely reliable preparation. 



Time of Administratii)n.- Antitoxin should be admin- 

 istered as earlv as possible on a clinical diag-nosis, not 

 waiting- for a l)acteriological culture. However late the 



