44 APPLIED IMMUNOLOGY 



the injection of antitoxin alone. Statistics showing 

 the increased incidence of cases of diphtheria in large 

 cities demonstrate the necessity for improvement in 

 methods of prevention, and it is hoped that this 

 method will fulfil its promise. Few statistics are 

 available as yet upon which to base conclusions. 



Curative Treatment of Diphtheria, — Antitoxin 

 should be used as early in the disease as possible, for 

 with every day of delay there is a great increase in the 

 mortality rate. The death-rate is practically nil in 

 patients who receive injections on the first day of the 

 disease. The average dose in the ordinary case when 

 seen on the first day is 5000 miits, regardless of the age 

 of the patient unless extremely young. In a severe 

 case the dose should be 10,000 or 15,000 units. In cases 

 seen later the dose should be proportionately larger, 

 sometimes as much as 100,000 units being given. 

 A single large dose of the serum is preferable to re- 

 peated smaller doses. Beneficial results should be 

 seen from the injection in about eight hours, charac- 

 terized by a subsidence of the throat symptoms and 

 fall of the temperature and pulse-rate. Otherwise 

 the injection may be repeated in larger dose. While 

 the administration of antitoxic serum is by far the 

 most important point in the treatment of diphtheria, 

 other measures, such as rest in bed, liquid diet, sprays. 



