DIPHTHERIA 199 



in virulence in a few cases where the B. coli was present. 

 Investigating this subject experimentally on guinea-pigs, 

 they obtained the same result, which is important, owing 

 to the ubiquity of the organism, and probably lends force 

 to the direction of using antiseptics locally as much as 

 possible. 



The Antitoxin Treatment of Diphtheria. — The discovery by 

 Behring and Kitasato, in 1890, of the existence of the anti- 

 toxic properties of the serum of the blood of animals 

 rendered immune to diphtheria, and their application of 

 this antitoxin to the cure of the disease, must be regarded 

 as one of the most important advances of the century in 

 the medical treatment of infective disease. The advantages 

 of the treatment, particularly on the Continent, have been 

 fully recognised by medical practitioners, and the results 

 that have been obtained have approximated in some cases- 

 to the prophecy of the discoverers, that the mortality 

 from the disease would be eventually reduced to five per 

 cent. 



The preparation and standardisation of diphtheric anti- 

 toxin has already been fully described under the section on 

 sero-therapy. See p. 128, et seq. 



The most suitable place for injection of antitoxic serum 

 is the subcutaneous tissue of the flank. The injection 

 should be made as soon as the disease is diagnosed, for the 

 earlier the treatment is commenced, the better the chance 

 of recovery. The quantity used must depend upon the 

 severity of the case, the strength of the antitoxin, and the 

 age of the patient. A severe case requires a dose larger 

 and more frequently repeated than a mild case. 



Great care should be taken to perform the injection with 

 strict aseptic precautions. The skin should be carefully 

 washed with soap and water, and subsequently with 1 in 

 20 carbolic lotion. The syringe should be boiled im- 



