"The free use of antitoxin does not raise the percentage of cases of albuminuria. As regards vomiting, the statistics give little information, as vomiting is usually met with only in the very severe cases. This also holds good of anuria. The number of cases of adenitis appears to be distinctly reduced by the use of antitoxin, as the percentage of cases falls as the injections of antitoxin are pushed. The use of antitoxin has also had a perceptible effect in diminishing the cases of nephritis, and it certainly has not aggravated the kidney complications of diphtheria. There can be no doubt that in cases treated with antitoxin there is a greater percentage of cases in which joint-pains occur than in cases not so treated; these, however, are transitory, and are probably the result of some slight change in the blood set up by the action of the serum itself, and not by the antitoxic substance in the serum. The number of primary abscesses has undoubtedly been reduced by the use of antitoxin. It may also be accepted that antitoxic serum has some effect in temporarily raising the temperature, but only during the periods of joint-pains and serum rashes; all these, however, are of comparatively slight importance as compared with the effect the antitoxin has in diminishing the percentage mortality and alleviating the more severe symptoms. "It is of importance to observe that amongst the cases of paralysis following diphtheria the death-rate (32 per cent.) was actually higher amongst those not injected with antitoxin than amongst those where antitoxin was used (30.5 per cent.), although the former paralyses must be looked upon as being the result of a comparatively mild attack of the disease. From this it is evident that, when once paralysis supervenes in these cases, it is quite as fatal in its effects as in the cases (usually those of a more severe type) where antitoxin has been given. Antitoxin _cannot cure_ the degeneration of the nerve, but it _can neutralise_ the diphtheria toxin, and so put a stop to the advance of the degenerative changes due to its action. In 1896, when, of course, antitoxin was given much more freely, the percentage of deaths in the non-injected cases where paralysis had come on fell to 18.4. "Antitoxin rashes occur at a comparatively late stage of the disease. They cannot be looked upon as in any way dangerous, although the secondary rise of temperature, and the irritation of the skin which usually accompany their presence are very undesirable complications, and may retard somewhat the convalescence of nervous and irritable patients. "Antitoxin appears to diminish the liability of the lungs to inflammatory change in severe attacks of diphtheria." * * * * *