arly release of
patients after recovery. It is a much safer method of procedure to
require at least two negative examinations before releasing a patient
from quarantine, as during convalescence the germs may be entirely absent
on one day and a few days later be quite abundant. The bacilli may remain
in the throat from a few days to several years after the disease is
apparently entirely well, and under such circumstances the persons
carrying them become quite as great, if not a greater, menace to those
with whom they came in contact as they were during the height of the
disease. A thorough disinfection of the room and everything used about
the sick person should be carried out after the patient is released.
Complete isolation should be observed during the illness, and as long as
the bacilli remains in the throat.

_Treatment._--Diphtheria antitoxin is the specific treatment of this
malady, and should be given early in the disease. The chances of recovery
decrease in proportion to the length of time existing between the onset
of the affection and the time of administration of the drug. Antitoxin
may be repeated in six hours after the initial injection if improvement
is not noticed, but ordinarily twenty-four hours should elapse between
doses. It is well to remember that it is safer to give too much antitoxin
than too little. The initial curative dose varies from 2,000 to 5,000
units, according to the age of the patient and the severity of the
disease. When a case is seen late it is often advisable to begin with a
large dose,--it being good practice under such circumstances to use at
once as much as 10,000 units or even more. The average case requires from
the beginning to the end of the treatment a total of from 10,000 to
20,000 units, but occasionally 50,000 or even 100,000 units may be
necessary. There are very few risks in giving antitoxin. In a series of
50,000 cases treated with it only two deaths occurred sufficiently early
after the injections to warrant the belief that this unhappy result was
produced by the drug. It is worth remembering that asthmatic cases bear
the administration of antitoxin very poorly; a marked and sometimes
serious embarrassment of respiration, with cyanosis, unconsciousness, and
general collapse may follow its use, but recovery is usual in such cases.

A condition known as anaphylaxis or hypersensitiveness, which at
present is being much studied, may sometimes occur in the human