134 



DIPHTHERIA 



" The lessened mortality is especially noticeable 

 in the earlier years of life, the percentage mortality 

 of children under five being 26.3, as opposed to 

 47.4. In the next period of five years, the per- 

 centage of mortality is 16.0, as opposed to 26.0; 

 whilst after ten years of age the difference in the 

 mortality is slight. # 



" Laryngeal diphtheria is admittedly the most 

 dangerous form. The laryngeal cases have a per- 

 centage mortality of 23.6 in the antitoxin, as com- 

 pared with 66.0 in the non-antitoxin series. In the 

 cases in which laryngeal symptoms are so severe as 

 to necessitate tracheotomy, the saving of life by the 

 use of antitoxin is very marked, the mortality being 

 reduced one-half, to 36.0 as opposed to 71.6 per cent. 



"The strongest evidence of the value of the 

 antitoxin treatment is that, in addition to reducing 

 the general mortality by one-third, the duration of 

 life in the fatal cases is decidedly prolonged. These 

 two facts taken together conclusively prove the 

 beneficial effects of the antitoxin treatment. 



"The incidence of paralysis is greater in the 

 antitoxin than in the control series. This increased 

 number is partly explained by the lessened mortality, 

 and partly by the longer duration of life in the fatal 

 cases affording time for the development of paralytic 

 symptoms. The percentage mortality of those who 

 had some form or other of paralysis is lower in the 

 antitoxin than in the control series ; so that, not- 

 withstanding the apparent greater risk of paralysis 



* After childhood, the disease is much less fatal. 



