122 BACTERIOLOGY FOR NURSES 



For curative purposes the horse-serum containing the 

 antitoxin of diphtheria, which is commonly known 

 as anti-diphtheritic serum, or still more commonly as 

 diphtheria antitoxin, is injected with a sterihzed 

 syringe into the loose subcutaneous tissue, usually 

 in the back, below the shoulder. Beginning with a 

 dose of 3000 or 4000 units, the dose is repeated about 

 every six hours, the size of the dose and the number 

 of times it is repeated being governed entirely by 

 the condition of the patient. 



The administration of diphtheria antitoxin is 

 sometimes followed by temporary pains in the joints, 

 or a rash. A few cases of death from the use of 

 diphtheria antitoxins are reported, the cause being un- 

 known, but is supposed to be due to some individual 

 idiosyncrasy. In proportion to the enormous num- 

 ber of injections constantly made the deaths are of 

 very rare occurrence. 



The only argument needed in favor of the use of 

 diphtheria antitoxin is its effect upon the death 

 rates from diphtheria. In New York the death rate 

 fell from 15.19 per 10,000 in 1885 to 6.62 per 10,000 

 in 1895; in Chicago from 14.29 per 10,000 in 1885 to 

 5.13 per 10,000 in 1895. 



Modes of Dissemination. — Diphtheria is more com- 

 mon in cold and temperate cUmates than in the 



