714 PASSIVE IMMUNIZATION SERUM THERAPY 



190G 37.78 



1907 34.60 



1908 33.35 



1909 33.6 



1910.. 31.7 



In Philadelphia, during the years 1909-10 and 1911, the average mor- 

 tality of diphtheria treated with antitoxin in the Philadelphia Hospital 

 for Contagious Diseases was 9.9 per cent., and in the private practice 

 of physicians, 13.07 per cent. In contrast to these figures is the mor- 

 tality of 40.34 per cent, in the private practice of those physicians 

 (fortunately few) who refused to give antitoxin or in those families op- 

 posed to its use. 



From Table 28 it will be seen that the average mortality in 13,106 

 cases of pure diphtheria treated with antitoxin in the Philadelphia Hos- 

 pital for Contagious Diseases during the past ten years was only 7.96 

 per cent. As stated elsewhere, when this is compared with the average 

 mortality of about 41 per cent, when no antitoxin was used, it is not diffi- 

 cult to appreciate the therapeutic value of the remedy. 



2. As was previously stated, it is also worthy of note that there is 

 practically no mortality in diphtheria cases receiving antitoxin on the 

 first day of illness. During nine consecutive years (1904-1913), covering 

 the treatment of 741 such cases in the Philadelphia Hospital for Contagious 

 Diseases, not a single death occurred. During 1913 two of the 51 first- 

 day cases died. 



It will also be noted from Table 28 that the patient's chance for re- 

 covery grows steadily less with each day that the administration of 

 serum is delayed, and this should be evidence enough to convince any 

 right-minded person that we possess in antitoxin a remarkable remedy 

 for the treatment of diphtheria. 



3. The influence of antitoxin is also noted in the mortality of laryn- 

 geal diphtheria. While the mortality in this condition is still high, ow- 

 ing to the frequency and dangers of bronchopneumonia and the necessity 

 for operative measures, it has been reduced at least one-half since anti- 

 toxin came into general use. Prior to 1896 the mortality was at least 

 70 per cent.; since then it has been reduced to 35 per cent, or less. As 

 shown in the following table, of 1207 cases treated in the Philadelphia 

 Hospital for Contagious Diseases, the average mortality was 35.6 per 

 cent. 



