DIPHTHERIA ANTITOXIN 



151 



the cases of paralysis following diphtheria the 

 death-rate (32 per cent.) was actually higher 

 amongst those not injected with antitoxin than 

 amongst those where antitoxin was used (30.5 per 

 cent.), although the former paralyses must be looked 

 upon as being the result of a comparatively mild 

 attack of the disease. From this it is evident that, 

 when once paralysis supervenes in these cases, it is 

 quite as fatal in its effects as in the cases (usually 

 those of a more severe type) where antitoxin has 

 been given. Antitoxin cannot cure the degenera- 

 tion of the nerve, but it can neutralise the 

 diphtheria toxin, and so put a stop to the advance 

 of the degenerative changes due to its action. In 

 1896, when, of course, antitoxin was given much 

 more freely, the percentage of deaths in the non- 

 injected cases where paralysis had come on fell to 

 18.4. 



" Antitoxin rashes occur at a comparatively late 

 stage of the disease. They cannot be looked upon 

 as in any way dangerous, although the secondary 

 rise of temperature, and the irritation of the skin 

 which usually accompany their presence are very 

 undesirable complications, and may retard some- 

 what the convalescence of nervous and irritable 

 patients. 



"Antitoxin appears to diminish the liability of 

 the lungs to inflammatory change in severe attacks 

 of diphtheria." 



Finally, there are Siegert's tables (1900), based 

 on no less than 40,038 cases, during nine years, in 

 sixty-nine hospitals, in Germany, Austria, Switzer- 

 land, and Paris. Securus judicat orbis terrarum. 

 Siegert divides the nine years into a "pre-serum 



