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Certain factors appeal to us in a severe case of laryngeal diphtheria. The main point to be considered, however, is to afford instantaneous mechanical relief and prevent asphyxia. This, to my mind, is of more importance than the consideration of what the real therapeutics shall be.
If therefore, a child has recovered from the exhaustion following this mechanical relief by intubation, then it is necessary to commence with the real therapeutic management of the case.
If a history of diphtheria exists, and we are positive of the diagnosis, then we should without delay inject our case with either 5 c.cm. of antitoxin of the strength of 500 normal units, and if no relief is afforded in twenty-four hours, then we repeat the injection of the same dose of antitoxin. The choice as to the location of the injection depends on the practitioner. My own preference has been, that seen by
FISCHER L. SOME PRACTICAL POINTS ON THE COMBINED EFECTS OF ANTITOXIN AND INTUBATION, WITH SPECIAL REFERENCE TO INFANT FEEDING IN MALIGNANT DIPHTHERIA. JAMA. 1896;XXVII(1):19–20. doi:10.1001/jama.1896.02430790019001f
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