234 PATHOGENIC BACTERIA, 



antitoxic treatment in diphtheria in the hospitals of the 

 world are probably those collected by Prof. Welch, who, 

 excluding every possible error in the calculations, u shows 

 an apparent reduction of case-mortality of 55.8 per cent." 



One of the most important things in the treatment is 

 to begin it early enough. Welch's statistics show that 

 1115 cases of diphtheria treated in the first three days 

 of the disease yielded a fatality of 8.5 per cent., whereas 

 546 cases in which the antitoxin was first injected after 

 the third day of the disease yielded a fatality of 27.8 per 

 cent. 



After the toxin has set up destructive organic lesions 

 in various organs and tissues of the body, no amount 

 of neutralization will restore the integrity of the parts, 

 so that the antitoxin must fail in these cases. 



The urticaria which sometimes follows the injection 

 of antitoxic serum seems to bear a distinct relation to 

 the age of the serum, fresh serums being more liable 

 to produce it than those which have been kept for a 

 week or two. 



The erythemata are probably in some way associated 

 with the globulicidal action of the blood. Keeping the 

 serum " until it is ripe " lessens this effect. The serums 

 from different horses probably vary much in both their 

 irritant and globulicidal properties, so that antitoxins 

 prepared by mixing the serums from a number of horses 

 are probably preferable to those from single horses. 



Dried serums are much less active than fresh ones. 



For purposes of immunization smaller doses than those 

 used for treatment suffice. According to Biggs, 2 cubic 

 centimeters are sufficient to give complete protection. 

 The immunity that results from the injection is of a 

 month or six weeks' duration. 



