duction and use of antitoxin in 1895, diphtheria could truthfully be called one of the greatest scourges of childhood. The death rate began to fall all over the civilized world with its increasing employment.
The following table, quoted from Keen, gives the official reports of the mortality from diphtheria for every 100,000 inhabitants in certain American and European cities before the use of antitoxin and after its employment had become general:
| Table of Mortality from Diphtheria | |||
| Per 100,000 Inhabitants | |||
| 1894 | 1905 | ||
| New York (Manhattan) | 158 | 38 | |
| Philadelphia | 128 | 32 | |
| Baltimore | 50 | 20 | |
| Boston | 180 | 22 | |
| Brooklyn | 173 | 43 | |
| Pittsburgh | 64 | 26 | |
| London | 66 | 12 | .2 |
| Paris | 40 | 6 | |
| Vienna | 114 | 19 | |
Later on, Dr. Park in a study of the average death rate from diphtheria in 19 large cities of the world in 1893 shows it to have been slightly over 80 per 100,000; in 1895, when the antitoxin treatment was introduced it began to fall, and by 1907, when antitoxin was generally employed, the rate had dropped to 17 per 100,000.
In the London hospitals the mortality has been reduced from 29 per cent, to about 10 per cent. The same is true of other large hospitals of the world.
These studies extending over widely diverse localities and long periods of time do away with such possible errors as varying severities of epidemics or chance local conditions.
Not only has the death rate been much lowered, but the severity of the disease and its complications have been marvellously changed for the better. Perhaps this is best seen in the great diminution of the fatal and agonizing croup cases, where the false membrane descends into the windpipe and causes death by slow strangulation. We wish those who are trying to throttle scientific research would witness the awful struggle of a child dying from diphtheritic croup. Fortunately even physicians are now seldom forced to go through such an ordeal, owing to the beneficent results of a treatment directly inaugurated as a result of animal research. At the Willard Parker Hospital, even the late and neglected cases of croup that have not had the remedy before admission, after a large, though belated dose of antitoxin now very rarely die from strangulation. If they succumb to other complications, they are at least mercifully spared the torture of prolonged strangling. Before anti-
