ANTITOXINS AND SERUM THERAPY. 61 



(7) Prolongation of life, in cases which terminate fatally, to an 

 extent not obtained with former methods of treatment. 



Statistics have also been brought forward which show, assuming 

 them to be reliable, a great reduction in the mortality after the 

 antitoxin treatment. A few instances may be quoted to illustrate 

 the statistical evidence. 



According to Behring, in the four years prior to the employment 

 of antitoxin, there were in Berlin 15,958 cases of diphtheria, with a 

 mortality of 35 '2 per cent. In 1894-5 there was an epidemic of 

 5,578 cases. Behring asserts that if the mortality had not been 

 reduced by the antitoxin treatment 1,963 would have died instead 

 of 1,056. Behring also states that in the Charity Hospital there 

 were 299 patients, with 53 deaths, or 16'7 per cent. In the Bethania 

 Hospital, where antitoxin was not employed, there were 249 

 patients, with 112 deaths, or 43 per cent. 



At Vienna, at the Anna Hospital for children, the mortality 

 in 760 cases was 50"65 per cent., but after the introduction of anti- 

 toxin there were 40 deaths in 159 cases, giving a mortality of 

 25'5 per cent. 



In New York, it is said that before the introduction of anti- 

 toxin the mortality ranged from 30'67 to 37"34, while in 1895, under 

 treatment with antitoxin, the mortality fell to 19 "43; but it was 

 also pointed out that since the introduction of antitoxin many 

 children with trifling attacks had been treated, and reported as 

 suffering from actual diphtheria, and that they would have recovered 

 without antitoxin, and therefore these cases have given the remedy 

 some credit which it does not deserve. 



In London, according to the Report of, the Medical Superin- 

 tendents of the hospitals of the Metropolitan Asylums Board there 

 were in 1894, before antitoxin was employed, 3,042 cases of 

 diphtheria with 902 deaths or 29'6 per cent., and in 1895, when 

 antitoxin was used, 3,529 cases with 796 deaths or 22'5 per cent. : 

 a reduction of 7'1 per cent, below that of 1894. The conclusions 

 drawn from the statistical and clinical observations are summed up 

 in the Eeport thus : — 



The improved results in the diphtheria cases treated during' the year 

 1895, are :— 



(I.) A great reduction in the mortality of cases brought under treat- 

 ment on the first and second day of illness. 



(II.) The lowering of the combined general mortality to a point 

 below that of any former year. 



(III.) The still more remarkable reduction in the mortality of the 

 laryngeal cases. 



