124 



DIPHTHERIA 



200,000 in 1897. The introduction of the serum 

 treatment has, however, had a marked effect on the 

 mortality of the disease ; and the actual number of 

 deaths from diphtheria has either not increased at 

 all, or has slightly diminished." [Lancet, 5th Aug. 

 1899.) 



Of course there will still be bad diphtheria years 

 and good diphtheria years : for example, the death- 

 rate of the population of England, from diphtheria, 

 was higher during the years 1893- 1899 tnan during 

 the years 1889- 1892. The following table, from 

 Gould's Year-Book for 1902, p. 647, gives the 

 death-rates from diphtheria and " croup" in 

 different countries for the years 1889- 1898. The 

 figures are expressed as a death-rate per 10,000 

 of the living population : — 



Year. 



Germany. 



Austria. 



Belgium. 



France. 



Holland. 



Switzerland. 



England. 



1889 . 



IO.9 



7-i 



3-9 



6.6 





6.0 



2.6 



1890 . 



IO.I 



7-3 



3-7 



6.1 





7.6 



2.4 



189I . 



8.5 



8.8 



3-3 



6.0 



4.9 



8.2 



2.1 



1892 . 



97 



9-5 



2.6 



5-4 



4-5 



5.2 



2.5 



1893 • 



12.6 



9.6 



4.0 



5.5 . 



4.0 



I0.2 



4.3 



1894 . 



10.2 



10.2 



4.6 



4.1 



3-3 



8.0 



3-8 



1895 . 



5-4 



6.3 



2.9 



1.9 



1.4 



3-4 



3-5 



1896 . 



4.3 



4.9 



1.6 



1.8 



2.5 



3-4 



3-9 



1897 . 



3-5 



4-7 



r.3 



1.2 



2.2 



3.o 



3-i 



1898 . 



3-4 



3-8 



1.4 



1.2 



i-7 



3-7 



3-i 



Antitoxin can no more prevent a bad diphtheria 

 year than an umbrella can prevent a wet day. But 

 in outbreaks of diphtheria such as occur in a village, 

 an asylum, a school, or a large family of young 

 children, it can be used, and is used, as a prophy- 

 lactic, and with admirable results. The example 



