[21] After childhood, the disease is much less fatal.
[22] For an exhaustive and wise study of the diphtheritic paralyses, see Dr. Woollacott's essay in the Lancet, 26th August 1899: "The use of antitoxic serum in the treatment of diphtheria has, up to the present time, in the London fever hospitals, had two main results—the death-rate has fallen, while the paralysis-rate has risen. In the hospitals of the Metropolitan Asylums Board, the former has been reduced from 29 per cent. to 15.3 per cent., while the latter has risen from 13 per cent. to as high as 21 per cent. in 1896. This increase of paralysis is chiefly due to the fact that many more patients now recover from the primary disease, and live long enough for paralysis to show itself. During the last two years, however, the occurrence of paralysis has begun to diminish in frequency.... The earlier antitoxin is given in diphtheria, the less likely is paralysis to follow." It is to be borne in mind that post-diphtheritic paralysis, in the great majority of cases, affects only a very small group of muscles; of Dr. Woollacott's tabulated cases, 377 were of this kind, and 97 were severe. And "the type of paralysis has, on the whole, become less severe, or at all events less dangerous to life."
[23] This, of course, does not apply to two instances, in 1901, of accidental contamination of serum. See, for an account of these, The British Medical Journal, November 1901.
[24] This sentence was written before the publication of Professor Negri's observations (see Medical Annual, 1906, p. 418).
[25] It is satisfactory to know that rabbits affected with rabies do not suffer in the same way as dogs and some other animals, but become subject to a painless kind of paralysis.
[26] "In order to prove that this vibrio is the cause of Asiatic cholera, several tests upon themselves have been voluntarily made by investigators in laboratories. These were carried out in Munich and in Paris. The results to the experimenters were sufficiently severe to indicate positively the pathogenic character of the spirillum, and its capacity to produce cholera-like infections. Such experimentation is, of course, to be deprecated; indeed, the occurrence of accidental laboratory infections, one of which ended fatally, furnished the necessary final proof of the specificity of the cholera vibrio, and rendered unnecessary any exposure to the risks belonging to voluntary inoculation." (Dr. Flexner, Stedman's Twentieth Century Practice, vol. xix., 1900.)
[27] Mr. Hankin, whose name is had in remembrance by Cambridge men, is Chemical Examiner and Bacteriologist to the North-West Provinces and Oudh, and to the Central Provinces.
[28] For a summary of this report, see the Lancet, 8th August 1896. For more recent results, see Surgeon-Captain Vaughan and Assistant-Surgeon Mukerji, in the thirtieth annual report of the Sanitary Commissioner for Bengal (1897). Also the note published by Surgeon-Captain Nott, in the Indian Medical Gazette, May 1898.
[29] "The moving into camp, notwithstanding this example, is all the same an excellent measure of defence, and would with reason be adopted in every outbreak." (Simpson, loc. cit.)
[30] The exact number is 355, of whom 196 were inoculated; the coolies numbered 343, and the Goorkhas 12. (See Dr. Simpson's 1896 Report.)