Now let us take another point of view. If anybody really doubts whether the antitoxin did really save these lives in the hospitals of the Metropolitan Asylums Board, what answer has he got to the following table? It is published in the Board's Report for 1904, and was drawn up by Dr. MacCombie, Medical Superintendent of the Brook Hospital. It shows the supreme importance of giving the antitoxin _at the very beginning of the disease_. The figures in brackets are the total numbers of the cases in the eight years:-- _Percentage Mortality according to Time of coming under Treatment._ +---------------+-----+-----+-----+-----+-----+-----+-----+-----+ |Day of Disease.|1897.|1898.|1899.|1900.|1901.|1902.|1903.|1904.| +---------------+-----+-----+-----+-----+-----+-----+-----+-----+ |(204) 1st | 0.0| 0.0| 0.0| 0.0| 0.0| 0.0| 0.0| 0.0 | |(1278) 2nd | 5.4| 5.0| 3.8| 3.6| 4.1| 4.6| 4.2| 5.43| |(1374) 3rd | 11.5| 14.3| 12.2| 6.7| 11.9| 10.5| 17.6|10.63| |(1086) 4th | 19.0| 18.1| 20.0| 14.9| 12.4| 19.8| 16.7|19.51| |(1382) 5th | | | | | | | | | | and after | 21.0| 22.5| 20.4| 21.2| 16.6| 19.4| 17.3|13.11| +---------------+-----+-----+-----+-----+-----+-----+-----+-----+ Here we see that in 1482 patients, who got the antitoxin within forty-eight hours of the onset of the disease, the mortality was 2-1/4 per cent. In 1278 patients, who did not get the antitoxin till the third day, the mortality was 11-3/4 per cent. That is the result of one day's delay over sending the child into hospital. Again, it is not only lives that are saved, but suffering that is avoided. Just lately, at a meeting of the Chelsea Clinical Society (May 1906), reference was made to this point by Dr. Foord Caiger, Medical Superintendent of the South-Western Hospital. "The number of tracheotomies is less than half what it used to be;" and again, "Instead of the spectacle of a number of patients in great distress, with swollen necks and stuffed-up noses, fretful and crying, such cases are now quite the exception, and, in the few one does come across, the condition lasts for a comparatively short time." And again, "It was quite unusual (before 1895) for a nurse to care to stay very long in charge of one of the diphtheria wards, because she found the work so depressing. But nowadays the diphtheria wards are perhaps the most popular in the hospital, a fact which is mainly owing to the change in the general aspect of the patients and the greatly reduced mortality." (_Clinical Journal_, May 23, 1906.) V TETANUS