The value of antitoxin in the treatment of diphtheria.

  • Research Defence Society (Great Britain)
Date:
1908
Catalogue details

Licence: In copyright

Credit: The value of antitoxin in the treatment of diphtheria. 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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    Supposing, now, that during a period of 5 years the prevalence of diphtheria were to be twice as great as during the preceding 5 years. If the severity of the disease remained unchanged, the death-rate in proportion to the general population would be approximately doubled, and it is absurd to expect that treatment, either by antitoxin or by any other means, could counteract such a largely increased death-rate. Unless, therefore, we know the number of cases of diphtheria during the period under consideration, it is quite impossible, from a study of the death-rate in proportion to the general population, to estimate the efficacy of antitoxin treatment; this can only be deduced from the case-mortality, that is to say, the percentage of deaths from diphtheria occ-urring amongst those who have contracted the disease. ii. It is impossible to estimate from any death-rate figures the value of antitoxin, unless we know in how many cases it was given. The truth of this statement is obvious. If antitoxin were given only in 5 per cent, of all diphtheria cases, the results, however brilliant, would not be reflected to any appreciable extent in the death-rate; whereas if it were given in every case we ought to be able to discover its effect, whether good or evil, from an examination of the case-mortality. The returns of the Registrar-General contain no information as to the number of cases treated by antitoxin, and the writer just quoted apparently assumes that since its introduction in 1895 it was given in every case of diphtheria. But this is very far from the truth. For, at first, antitoxin was reganded with a good deal of uncertainty and suspicion by the medical profession, so that only a small proportion of patients were treated in this way ; and it is only of recent years, after passing