"But even these figures do not adequately express the benefit of antitoxin in laryngeal cases. Witness the fact that over one-half the laryngeal cases did not require operation at all. Formerly, 10 per cent. of recoveries was the record for laryngeal cases not operated upon. Surely, if it does nothing else, the serum saves at least double the number of cases of laryngeal diphtheria that has been saved by any other method of treatment."
III
In 1898, the Clinical Society published the Report of their Special Committee, based on 633 cases (Trans. Clin. Soc., xxxi., 1898, pp. 1-50). The whole report should be read carefully; but there is room here for nothing more than the latter part of it. This is given at length.
A
Table showing the General Mortality of cases treated, on the same
day of the disease, with and without Antitoxin.
| Antitoxin Committee: 633 Cases treated with Antitoxin. | Metropolitan Asylums Board 1894: 3042 Cases treated without Antitoxin. | Difference of Percentage. | ||||||
|---|---|---|---|---|---|---|---|---|
| Day of the | C | D | M | Day of | C | D | M | |
| Disease on | a | e | o | Admission | a | e | o | |
| which | s | a | r | to | s | a | r | |
| Treatment | e | t | t | Hospital | e | t | t | |
| was begun. | s. | h | i | s. | h | a | ||
| s. | l | s. | l | |||||
| i | i | |||||||
| t | t | |||||||
| y. | y. | |||||||
| % | % | |||||||
| 1st | 20 | 2 | 10.0 | 1st | 133 | 30 | 22.5 | 12.5 |
| 2nd | 92 | 10 | 10.8 | 2nd | 539 | 146 | 27.0 | 16.2 |
| 3rd | 133 | 20 | 15.0 | 3rd | 652 | 192 | 29.4 | 14.4 |
| 4th | 130 | 26 | 20.0 | 4th | 566 | 179 | 31.6 | 11.6 |
| 5th | 258 | 66 | 25.5 | 5th | 1,152 | 355 | 30.8 | 5.3 |
| and after. | ||||||||
| Totals | 633 | 124 | 19.5 | Totals | 3,042 | 902 | 29.6 | 10.1 |
B
Summary and Conclusions of the Committee's Report
"The material for the investigation of the clinical value of the antitoxin serum in the treatment of diphtheria was not obtained from selected, but from consecutive, cases, reported from the general hospitals and the fever hospitals of the Metropolitan Asylums Board; all were made use of which fulfilled the requirements of the Committee.
"The Committee rejected all cases in which satisfactory proof of the existence of true diphtheria was not shown, either by the presence of the Bacillus diphtheriæ upon bacteriological examination, or by the occurrence of paralysis in the course of the illness. All were also rejected in which the amount of antitoxin administered was stated in cubic centimetres and not in normal units, the Committee having no means by which the strength of the antitoxin could in these cases be determined.
"Six hundred and thirty-three cases form the basis on which the report is drawn up; 549 were treated with antitoxin obtained from the laboratory of the Royal Colleges of Physicians and Surgeons; the remainder, 84 in number, were injected with antitoxin obtained from other sources. In nine instances, antitoxin from two different sources was injected into the same patient.
"Statistics of the disease before the use of antitoxin are introduced as control series; these were obtained from the fever hospitals of the Metropolitan Asylums Board, and from the general hospitals; and, like the antitoxin series, are compiled from consecutive and not from selected cases.