13 
diphtheria patients is considerable and each case is, as a rule, kept 
long enough for paralysis to develop: 
1893. 
1894. 
1895. 
1896. 
1897. 
1898. 
1899. 
1900. 
1901. 
1902. 
1903. 
1904. 
1905. 
1906. 
Year. 
Number 
admitted. 
2,848 
14.2. 
3, 666 
13.1. 
3,635 
20.4. 
4,508 
20.5. 
5, 637 
20.55. 
6, 566 
19.42. 
7,066 
20.0. 
7,195 
18.50. 
6,926 
15.0. 
6,534 
17.07. 
5,072 
17. 1. 
4, 687 
14. 8. 
4,148 
12. 4. 
5,218 
10.9. 
Percentage of paralysis cases. 
Pre-antitoxin year. 
Only a few cases injected. 
General employment of antitoxin. 
It is plain from the above figures that while the percentage of 
paralysis during the years following the introduction of antitoxin is 
higher than in 1893 and 1894, in recent years a decrease is evident; 
this is probably due to larger dosage and earlier administration of 
serum. The medical superintendents of these hospitals pointed out 
in 1895 that there is more than one explanation of the increase first 
noted. In the first place, cases that before would have died in the 
acute stage now survive and suffer those palsies which before were 
found only in the less severe cases. Secondly, the new treatment 
aroused fresh interest in diphtheria and stimulated more careful 
clinical observation. 
• Holiest on expresses the emphatic opinion that antitoxic treatment 
does not make paralysis more liable to ensue. He states that the 
early administration of antitoxin makes paralysis less likely to occur, 
especially in the severe form. He gives the following figures in 
support of his views: 
Day of the disease. 
Paralysis 
cases. 
Percent- 
age. 
Severe 
forms 
onlj\ 
Percent- 
age. 
First day 
1 
5.5 
0 
0.0 
Second day 
16 
15.09 
4 
3.7 
Third day 
28 
18.7 
8 
5.3 
Fourth day 
27 
28.7 
12 
12.7 
Fifth day 
21 
35.0 
5 
8.3 
Sixth day 
15 
34.9 
10 
23.2 
Seventh day 
4 
19.4 
. 1 
4.7 
Ninth day 
1 
50.0 
0 
Eleventh day 
1 
50.0 
1 
50.0 
Thirtieth day 
1 
100.0 
1 
50.0 
Total 
115 
41 
i 
