88 MODERN BIOLOGIC THERAPEUSIS 



titoxin itself are very remote in contrast to the 

 beneficial results which will follow if the dis- 

 ease proves to be true diphtheria. 



Nasal diphtheria is a form of the disease 

 which too often goes undetected by the prac- 

 titioner. The infant with persistent snuffles 

 should be regarded as a suspicious case of nasal 

 diphtheria. Such cases are best handled by ad- 

 ministering antitoxin at once and taking a cul- 

 ture from both nostrils. 



Deciding on Proper Dose When a physi- 

 cian is called to see a case of diphtheria he 

 should diagnose the case comprehensively, tak- 

 ing into consideration the probable virulence 

 of the infection as indicated by the extent of 

 false membrane and the constitutional symp- 

 toms and the rapidity with which toxic symp- 

 toms have appeared after the onset of the dis- 

 ease. Then he should administer a dose of 

 antitoxin which he believes will be sufficient for 

 controlling the entire course of the disease. 

 Second injections should not be required un- 

 less the necessary dosage at the first injection 

 has been under-estimated. Therefore, it is far 

 better if 20,000 units are expected or intended to 

 be used in a given case, for the entire amount 



