SERUM THERAPY 93 



is held back. The rate of subcutaneous absorp- 

 tion is shown in the following table by Park : 



10 per cent in 6 hours, 

 35 per cent in 24 hours, 

 65 per cent in 48 hours, 

 100 per cent in 72 to 96 hours. 



The slowness of absorption of antitoxin injected 

 subcutaneously is very evident from this table, 

 showing as it does that it requires forty-eight to 

 seventy-two hours for the absorption into the 

 blood of the greater part of the antitoxin. This 

 in severe cases may be a fatal delay. 



TREATMENT OF LATE CASES 



In hospital practice many patients do not re- 

 ceive the first dose of antitoxin before the sixth 

 or seventh day, or even later, owing to the fact 

 that in most of the cases admitted the disease 

 has reached the advanced stage. In such ad- 

 vanced cases and in septic cases, which have 

 been ill six to seven days and with necrotic mem- 

 brane of extremely foul odor, Diphtheria Anti- 

 toxin may be given in enormous doses, ranging 

 from 20,000 to 50,000 units, and should be given 

 intravenously. 



