toxin days, two thirds of the croup cases that were tubed died at this hospital; now three quarters are saved. It is hard to realize what such figures actually mean. In the years preceding the discovery of the germ that causes diphtheria and the working out of its antidote, among the cases reported as dying from diphtheria, more than 75 per cent, were attributed to diphtheria of the windpipe.
Antitoxin, when early and properly given, will not only cure in a majority of cases but likewise immunize those closely exposed to the infection of the disease. Over 35,000 cases were thus treated by the New York Board of Health without any serious sequel.
Cerebro-Spinal Meningitis
One of the most fatal and distressing diseases, confined largely to children, is epidemic and sporadic cerebro-spinal meningitis. Before the working out of the anti-meningitis serum by careful, scientific experimentation on animals, there was no method of preventing the growth, and appalling effects of the meningococci that caused the disease. Now we have a serum that not only directly destroys or inhibits the growth of the germs, but also indirectly acts by stimulating the white blood cells to overcome the germs. At the same time a neutralizing action is exerted on the soluble and diffusible poisons that are secreted by the deadly meningococci. As a result, not only has the mortality been greatly lowered, but the severe symptoms and crippling complications have been most favorably influenced. The lowest mortality before the serum treatment ran from about 50 per cent, in sporadic cases to 75 per cent, in the epidemic form in different parts of the world. When the serum is now given by spinal puncture, the mortality drops to about 25 per cent, or even lower. If the serum is given early in the disease, the altered mortality is still more remarkable. The following table quoted by Dunn from the studies of Dopter shows this feature:
Mortality in Epidemic Meningitis under Serum Treatment
Cases Analyzed According to Period of Injection
| Flexner Per Cent. |
Netter Per Cent. |
Dopter Per Cent. | |
| First to third day | 14.9 | 7.14 | 8.2 |
| Fourth to seventh day | 22.0 | 11.1 | 14.4 |
| Later than seventh day | 36.4 | 23.5 | 24.1 |
In cases that recover, the serum treatment not only shortens the duration of the disease—sometimes by several weeks—but lessens the chances of the terribly destructive sequelæ, such as hydrocephalus, blindness and deafness.
