AND THE HEALING ART 511 



of the world, and it has gradually made its way more and more into the confidence 

 of the profession. One important piece of evidence in its favour in this country 

 is derived from the report of the six large hospitals under the management of 

 the London Asylums Board. The medical officers of these hospitals at first 

 naturally regarded the practice with scepticism : but as it appeared to be at 

 least harmless, they gave it a trial ; and during the year 1895 it was very generally- 

 employed upon the 2,182 cases admitted ; and they have all become convinced 

 of its great value. In the nature of things, if the theory of the treatment is 

 correct, the best results must be obtained when the patients are admitted at 

 an early stage of the attack, before there has been time for much poisoning of 

 the system ; and accordingly we learn from the report that, comparing 1895 

 with 1894, during which latter year the ordinary treatment had been used, the 

 percentage of mortality, in all the six hospitals combined, among the patients 

 admitted on the first day of the disease, which in 1894 was 22-5, was onlv 4-6 in 

 1895 ; and for those admitted on the second day the numbers are 27 for 1894 and 

 148 for 1895. Thus for cases admitted on the first day the mortality was onl\' 

 one-fifth of what it was in the previous year, and for those entering on the 

 second it was halved. Unfortunately in the low parts of London which furnish 

 most of these patients the parents too often delay sending in the children till 

 much later ; so that on the average no less than 675 per cent, were admitted on 

 the fourth day of the disease or later. Hence the aggregate statistics of all cases 

 are not nearly so striking. Nevertheless, taking it altogether, the mortalit\- in 

 1895 was less than had ever before been experienced in those hospitals. I should 

 add that there was no reason to think that the disease was of a milder type than 

 usual in 1895 ; and no change whatever was made in the treatment except as 

 regards the antitoxic injections. 



There is one piece of evidence recorded in the report which, though it is not 

 concerned with high numbers, is well worthy of notice. It relates to a special 

 institution to which convalescents from scarlet fever are sent from all the six 

 hospitals. Such patients occasionally contract diphtheria, and when they do 

 so the added disease has generally proved extremely fatal. In the Wvc years 

 preceding the introduction of the treatment with antitoxin the niortahty from 

 this cause had never been less than 50 per cent., and averaged on the \\ hole big 

 per cent. During 1895, under antitoxin, the deaths among the 119 patients of 

 this class were only 75 per cent., or one-eighth of what had been previously 

 experienced. This very striking result seems to be naturally explained b\- the 

 fact that these patients being already in hospital when the diphtheria appeared, 

 an unusually early opportunity was afforded for dealing with it. 



There are certain cases of so malignant a character from the hrst that no 



