Evening star., 1896-11-30

menD anti-toxin is tried"
WAS the result Of this investigation IA
vorable to the use of anti-toxin?"
AS the result Of this investigation of g.
I94 cases, the conclusions of the committee
we're entirely favorable. The number Of
cases In which the patients appeared to
have been made worse by serum were
three and among these there is only one
new case In which the result may fairly be
attributed to the injection. The general
mortality In the 5,794 cases reported was
12.3 per cent, excluding the cases moribund
at the time of injection, or dying within
twenty-four hours. 1t was SS per cent. The
most striking improvement was seen in the
cases injected during the first three days.
Of 412O such cases the mortality was 1.3
per cent: excluding cases moribund at the
time of injection. or dying within twenty
four hours. 1t was 4.s per cent. The NOR
taity of ,44S cases injected on or after the
fourth day was p per cent.
Fine Record.
"The most convincing argument and to
the minds Of the committee, an absolutely
uranswerable one in favor of serum ther-
apy, is found in the results obtained in the
1.256 laryngeal cases (membranous croup).
In one-half of these recovery took place
without operation, in large proportion Of
which the symptoms of stenosis were Sc
we're. OF the 5:53 cases in which intubation
was performed. the mortality was $50 per
cent, or less than half as great has ever
been reported by any other method Of
treatment.
The proportion of cases of broncho-
pneumonia, 80 per cent. is very small. and
IN striking contrast to results published
from hospital sources.
AS against the two three instances in
which the serum is believed to have acted
unfavorably upon the heart might be cited
a large number in which there was dis
tinct improvement in the hearts action
after the serum was injected. There is
very little, if any, evidence to show that
neDhritiS so hI {r-
lection of serum. The number of cases of
genuine nephritis is remarkably small the
deaths from that source numbering but
fifteen. The effect of the serum on the
nervous system is less marked than upon
any other part of the body: paralytic Sc
qulae being recorded in 81 per cent of the
cases, the reports going to show that the
protection afforded by the serum is not
great unless injections are made very
early
Did the action of the committee meet
with the approval of the society?"
The report was unanimously adopted
and the committee requested to continue its
investigations
What did the returns from the District
of Columbia show?
In the District.
Acting independently of the committee
1 prepared paper, entitled Comparative
Results of the Treatment of Dipththeria
With and Without it's Anti-Toxin in the
L
Montreal meeting. and in which | said:
In the prosecution of the work of COL
lecting the data relative to the treatment
Of diphtheria in children, with it's anti
toxin. In private practice in the District of
Columbia, cases of diphtheria in which
the serum was not used formed such a
large proportion of the whole number that
they have been incorporated in this paper
for purposes of comparison. 1t must be
understood taat information asked for in
the circular was not sought in the latter
class of cases. All cases Gid of diphtheria,
except ten, officially recorded occurring in
the District of Columbia from January l,
1s95 to April IL. 1886 are Included in this
paper. The exclusion of seven of the ex
ceptional cases was because the bacilli
diphtheriae We're present without the mem
brane and the injection being used for i'm
mUnization, and in the other three it was
impossible to obtain any information from
the two reporters which would enable
classification. While the physicians them
selves have furnished the details in the
cases treated with serum, the official rec
ords of the health department have been
relied upon in the other cases.
During the period named SO physicians
treated 116 cases Of diphtheria with anti
toxin. OF these, II reported 100 cases in
full. while II, who had treated the remain
ing Ii cases. did not respond. The latter.
however, are covered in this report. as
sufficient information was CLEANED from
other sources to warrant proper classifica-
tion During the same time ~ physicians
treated 13o cases of diphtheria without
using its anti-toxn. A third class of -
physicians, used the anti-toxin in 56 cases,
but did not use 1t in 3S.
During the year ending June 30, 1894,
before the Introduction of anti-toxin, 432
cases of diphtheria were reported in this
District, the average age Of those attacked
being 81 years. There were 112 deaths,
the percentage of deaths to cases being 1913.
During the fifteen and a half months
ending April u. 1896. after the introduc-
ticn of anti-toxin, 81 cases of diphtheria
were reported. the average age of those at
tackled being 6.23 years. There were seven
ty-three deaths, the percentage of deaths
to all cases being 23.44.
During this same period 135 cases
were treated without anti-toXin, the aver
age being 5.96 years. There were forty
seven deaths, the percentage of deaths to
all such cases being 34.S1, death rate of
only 4.99 per cent less than that when anti
toxin was unknown, the average age of the
decedents being 42j years.
During this period also 176 cases were
treated by the infection of anti-toxin, the
average age being 6.51 years There were
twenty-siX deaths, the percentage of deaths
to all cases receiving the anti-toxin being
14.17, the average age of the decedents be-
ing 1866 years. There were twenty-five
physicians who used anti-toxin in fifty-sx
cases. but did not use 1t in thirty-eight
cases during the same period
Why 1t Sometimes Fails.
I'm the latter group there were eleven
deaths, the death rate being 1884 per cent:
in the former. in which it was generally ad-
mitted by the physician reporting that the
anti-toxin had been administered because
of the failure to obtain results from the
usual remedies, there were but fourteen, a
percentage of deaths to cases of only %,
even less, it will be noted, than the death
rate In the milder cases not SO treated.
None of the physicians reported cases in
which the injection of anti-toXn resulted
injuriously to the patient.
II know of no physician other than DR..
Winters who. after having given the reme
dy fair trial, has discontinued its USE
"How do you account for the failure OF
this remedy in certain cases?'
There are some cases of the disease
which must be recognized as malignant
from the very outset, as is frequently the
case in other contagious diseases. depend
ing apparently upon the extent of exposure
to the contagion feeble resisting powers
of the individual. Such cases may be ex-
pected to die in spite of any treatment.
Aside from this, failure in cases other than
these may be attributed most frequently to
delay in it's administration, the best results
being obtained If 1t Is given prior to the
fourth day, or to its use in insufficient
quantities..
The Star reporter having referred to the
charge that this remedy is being pushed by
It's manufac turers for mercenary purposes,
rather than by physicians, Dr. Adams said
"Anti-toXin is not manufactured under
any secret formula or under letters pat