SERUM TREATMENT OF DIPHTHERIA 



767 



TABLE 29. MORTALITY OF LARYNGEAL DIPHTHERIA (INTUBA- 

 TION CASES) IN THE PHILADELPHIA HOSPITAL FOR 

 CONTAGIOUS DISEASES 



(This table excludes those patients dying in the ambulance and moribund 

 cases dying within twenty-four hours.) 



Formerly when a child contracted diphtheria the parents were 

 warned of the likelihood and danger of the infection involving the larynx 

 and trachea; nowadays this possibility is quite remote. 



4. Finally the claim of the opponents of the serum therapy of diph- 

 theria that antitoxin increases the percentage of paralyses is without 

 foundation. While it is true that this percentage is somewhat higher 

 than was noted in former years, this increase is to be explained by the 

 fact that antitoxin saves a larger number of severe cases long enough 

 for them to manifest paralyses, and, second, by the greater attention 

 that has recently been directed to its milder forms. Since diphtheric 

 paralysis is regarded as caused by toxone or a later secondary toxic 

 product of the bacilli, the indications are to rid the patient of the bacilli 

 as quickly as possible, and this is best and most surely accomplished by 

 the proper administration of antitoxin. 



PROPHYLACTIC IMMUNIZATION AGAINST DIPHTHERIA 

 The subcutaneous administration of relatively small doses of anti- 

 toxin will usually confer a passive immunity against diphtheria lasting 

 from two to four weeks. 



The object is to introduce antibodies (antitoxin and opsonin) into the 

 body-fluids in order that they may neutralize the toxin as rapidly as it 

 is produced, aid in the destruction of the bacilli, and thus protect the 



