502 Chapter XV 



produce their action for a very short time only, for a few weeks at 

 most. Of the five fatal cases, four did not occur until 2, 4J, 6, and 

 9J months respectively after the protective inoculation. It is im- 

 possible to look upon these statistics as affording proof of the 

 inefficacy of the serum. The fifth case is the only one that occurred 

 within a short time (15 days) of the injection, and in this instance 

 only 150 immunising units had been injected. 



A detailed study of the other examples of antidiphtheria inocu- 

 lations in the government of Kherson leaves a very favourable im- 

 pression. Out of 90 children inoculated by Wecker 1 in the district 

 of Elisabetgrad not a single one contracted diphtheria, which is the 

 more remarkable as at the time of the inoculations there existed in 

 the same families 14 cases of diphtheria; the chances of contamination 

 were thus great. 



Recently, on the occasion of the outbreak of a great epidemic in 

 Paris, the question of vaccinations by serum was again raised and 

 earnestly discussed at the Paris Hospitals Medical Society and at the 

 Society for the Study of Children's Diseases. Voisin and Guinon 2 

 communicated the history of an epidemic amongst the staff at the 

 Salpetriere Hospital in the wards of idiot children, "against which 

 protective serum treatment was remarkably effective and absolutely 

 innocuous." The serum was injected, in the case of children more 

 than 10 years of age, in 10 c.c. doses, and into the rest in 6 c.c. doses. 

 This measure brought about first an abatement and then cessation 

 of the epidemic. The immunity after a single injection lasted from 

 two to three weeks, and the few cases of diphtheria which broke out 

 amongst the infected children were distinguished by their great 

 mildness. Erythemata and other post-injection complications were 

 insignificant, so that the protective use of the serum was fully 

 justified. Only a small minority of the medical men who took part 

 in the discussion spoke against the antidiphtheria vaccinations ; 

 once, indeed, a reference was made to the case of Langerhans's child, 

 although its death was certainly not due to the serum. It is true 

 that in families where it is possible to keep the children under 

 careful observation and to intervene at the appearance of the first 

 [526] symptoms of diphtheria, the preventive injections may be dispensed 

 with, but in practice these favourable conditions are rarely realised, 



1 Chron. mtd. d. gouvern. de Kherson, 1896, No. 19, p. 743. 

 * Bull, et mem. Soc. med. des Hop. de Paris, 1901, p. 585. 



