Intramuscular injections of antitoxin in the treatment of diphtheria / by J.D. Rolleston and C. Macleod.

  • Rolleston, John Davy, 1873-1946.
Date:
1914
Catalogue details

Licence: In copyright

Credit: Intramuscular injections of antitoxin in the treatment of diphtheria / by J.D. Rolleston and C. Macleod. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    A recent visit by one of us (J. D. R.) to Prof. Schlossmann’s clinic at Diisseldorf, where we were assured by Dr. J. Bauer of its harmlessness and simplicity, induced us to make a trial of the method. The present paper is based on our experience of the last six months, during which period, thanks to the collaboration of our colleagues, intramuscular have entirely supplanted subcutaneous injections at the prove Hospital. In all, 412 injections have been given to 339 patients, whose ages ranged from two weeks to thirty-seven years, but only 35 were above the age of fifteen years. After subtracting 33 cases still under treatment, as well as 45 patients who, after injection, were found not to have diphtheria, 261 completed cases of diphtheria, to whom 324 injections were given, are left. Fifteen died, a mortality of 5-7 per cent., which is reduced to 4’6 per cent, on excluding 3 cases who died within twenty-four hours of admission. Classification and Dosage. The cases have been classified according to the localisation of the membrane and the character of the attack, as follows: Table I.—Classification of Cases. 1. Faucial cases with or without nasal or laryngeal involvement : Severe ...... 67 Moderate ...... 45 Mild 117 2. Nasal cases only : Mild 17 3. Laryngeal cases only : Severe ...... 9 Moderate ...... 2 Mild 2 4. Conjunctival only : Mild 1 5. Aural only ; Mild 1 Total 261 The severe faucial cases received from 16,000 to 20,000 units on admission, usually the same, but sometimes a smaller dose, being- repeated if necessary on one or two of the following days. The