6i6 
Antitoxins. 
/Am.  Jour.  Pharm. 
{  November,  1896. 
immunity  to  the  poison  perpetually  secreted  by  the  microbes,  but 
the  bacilli  might,  by  their  growth  and  extension,  cause  obstruc- 
tion of  the  respiratory  passages. 
Roux,  however,  whose  name  must  always  be  mentioned  with 
honor  in  relation  to  this  subject,  effectually  disposed  of  this  diffi- 
culty. He  showed  by  experiments  on  animals  that  a  diphtheritic 
false  membrane,  rapidly  extending  and  accompanied  by  surround- 
ing inflammation,  was  brought  to  a  stand  by  the  use  of  the  anti- 
toxin, and  soon  dropped  off,  leaving  a  healthy  surface.  What- 
ever be  the  explanation,  the  fact  was  thus  established  that  the 
antitoxic  serum,  while  it  renders  the  toxin  harmless,  causes  the 
microbe  to  languish  and  disappear. 
No  theoretical  objection  could  now  be  urged  against  the  treat- 
ment, and  it  has,  during  the  last  two  years,  been  extensively  tested 
in  practice  in  various  parts  of  the  world,  and  it  has  gradually 
made  its  way  more  and  more  into  the  confidence  of  the  profes- 
sion. One  important  piece  of  evidence  in  its  favor  in  this  coun- 
try is  derived  from  the  report  of  the  six  large  hospitals  under 
the  management  of  the  London  Asylums  Board.  The  medical 
officers  of  these  hospitals  at  first  naturally  regarded  the  practice 
with  skepticism ;  but  as  it  appeared  to  be  at  least  harmless,  they 
gave  it  a  trial,  and  during  the  year  1895  it  was  verv  generally 
employed  upon  the  2,182  cases  admitted,  and  they  have  all  become 
convinced  of  its  great  value.  In  the  nature  of  things,  if  the  theory 
of  the  treatment  is  correct,  the  best  results  must  be  obtained  when 
the  patients  are  admitted  at  an  early  stage  of  the  attack,  before 
there  has  been  time  for  much  poisoning  of  the  system  ,  and,  accord- 
ingly, we  learn  from  the  report  that,  comparing  1895  with  1894, 
during  which  latter  year  the  ordinary  treatment  had  been  used,  the 
percentage  of  mortality — in  all  the  six  hospitals  combined — among 
the  patients  admitted  on  the  first  day  of  the  disease,  which  in  1894 
was  22-5,  was  only  4-6  in  1895 ;  while  for  those  admitted  on  the 
second  day  the  numbers  are  27  for  1894  and  14-8  for  1895.  Thus, 
for  cases  admitted  on  the  first  day,  the  mortality  was  only  one-fifth 
of  what  it  was  in  the  previous  year,  and  for  those  entering  on  the 
second  it  was  halved.  Unfortunately,  in  the  low  parts  of  London, 
which  furnish  most  of  these  patients,  the  parents  too  often  delay 
sending  in  the  children  till  much  later  ;  so  that  on  the  average  no 
less  than  67-5  per  cent,  were  admitted  on  the  fourth  day  of  the  dis- 
