DIPHTHEBIA 167 



Advantages of the Treatment. — In many cases the injec- 

 tion is followed by a speedy reduction in the severity of the 

 symptoms, and a rapid separation of the membrane, in 

 cases where it was causijig obstruction of the air-passages, 

 thus diminishing the number of cases which would other- 

 wise require tracheotomy. 



Disadvantages and Difficulties. — One of the principal draw- 

 backs to the antitoxin treatment is the difficulty of judging 

 the quantity of injection that will be most beneficial, 

 and of late much larger quantities have been employed, 

 with more satisfactory results. It is hardly necessary 

 to remark that the greatest care must be taken to ensure 

 sterility of the injecting syringe, and if the whole of a bottle 

 of serum is not used at once, it must be thrown away. 



It is at present somewhat early to form very decided 

 opinions of the value of the treatment, but we may be 

 satisfied that in very many cases distinct benefit has 

 resulted. The treatment is, however, not suitable for every 

 case, and is, except in experienced hands, not entirely free 

 from danger, and should preferably be employed not later 

 than the third day of the disease. 



Injections of serum are often followed by the appearance 

 of various rashes, sometimes erythematous, at other times 

 urticarial, and in a few cases not at all unlike the rash of 

 scarlet fever or of measles. These rashes usually come on 

 in from seven to ten days after the injection ; sometimes 

 the rash is accompanied by more or less pyrexia, and in a 

 small number of cases by pains, and even effusion into 

 some of the joints. It has been alleged by some that the 

 injection of serum has actually been the cause of nephritis, 

 but this is contrary to the experience of those who have had 

 the best opportunities of observing the effects of serum in 

 an extended number of cases. 

 ,. Louis Corbett {Journal of Pathology and Bacteriology, 



