470
DIRSCHAU —DIVIDEND
Since antitoxin was introduced in 1894 it has overshadowed all other methods of treatment. We owe this drug originally to the Berlin school of bacterireatmeat. 0j0g^gj;g) an(j particularly to Dr Behring. The idea of making use of serum arose about 1890, out of researches made in connexion with MetschnikofFs theory of phagocytosis, by which is meant the action of the phagocytes or white corpuscles of the blood in destroying the bacteria of disease. It was shown by the German bacteriologists that the serum or liquid part of the blood plays an equally or more important part in resisting disease, and the idea of combating the toxins produced by pathogenic bacteria with resistant serum injected into the blood presented itself to several workers. The idea was followed up and worked out independently in France and Germany, so successfully that by the year 1894 the serum treatment had been tried on a considerable scale with most encouraging results. Some of these were published in Germany in the earlier part of that year, and at the International Hygienic Congress, held in Budapest a little later, Dr Roux, of the Institut Pasteur, whose experience was somewhat more extensive than that of his German colleagues, read a paper giving the result of several hundred cases treated in Paris. When all allowance for errors had been made, they showed a remarkable and even astonishing reduction of mortality, fully confirming the conclusions drawn from the German experiments. This consensus of independent opinion proved a great stimulus to further trial, and before long one clinique after another told the same tale. The evidence was so favourable that Professor Virchow—the last man to be carried away by a novelty—declared it “ the imperative duty of medical men to use the new remedy” (The Times, 19th October 1894). Since then an enormous mass of facts has accumulated from all quarters of the globe, all testifying to the value of antitoxin in the treatment of diphtheria. The experience of the hospitals of the London Metropolitan Asylums Board for five years may be given as a particularly instructive illustration, because it represents a prolonged experiment on an immense scale, and because the mortality was already comparatively low in those hospitals before the use of antitoxin.
expression of the children is brighter and more lively.” Adult patients have described the relief afforded by inoculation; it acts like a charm, and lifts the deadly feeling of oppression off like a cloud in the course of a few hours. Finally, the counteracting effect of antitoxin in preventing the disintegrating action of the diphtheritic toxin on the nervous tissues has been demonstrated pathologically. There are some who still affect scepticism as to the value of this drug. They cannot be acquainted with the evidence, for if the efficacy of antitoxin in the treatment of diphtheria has not been proved, then neither can the efficacy of any treatment for anything be said to be proved. Prophylactic properties are also claimed for the serum; but protection is necessarily more difficult to demonstrate than cure, and though there is some evidence to support the claim, it has not been fully made out. Authorities.—Adams. Public Health, vol. vii.—Thorne Thorne. Milroy Lectures, 1891. — Newshot.me. Epidemic Diphtheria.—W. R. Smith. Harben Lectures, 1899.— Murphy. Report to London County Council, 1894.—Sims Woodhead. Report to Metropolitan Asylums Board, 1901. (x. Sl. ) Dirschau, a town of Prussia, province of West Prussia, on the left bank of the Vistula, 20 miles south from Danzig and at the junction of important lines of railway. The river is here crossed by two fine iron bridges. The older structure dating from the year 1857, originally used for the railway, is now given up to road traffic, and the railway carried by a new bridge completed in 1891. Dirschau has railway workshops and manufactories of sugar, agricultural implements, and cement. During the war with Poland, Gustavus Adolphus made it his headquarters for many months after its capture in 1626. Population (1885), 11,146; (1900), 12,808. Distribution.
See Zoological Distribution.
District Of Columbia.. See Washington, the capital of the United States. Dittersbach, a village of Prussia, prov. Silesia, 3 miles by rail south-east from Waldenburg and 50 miles south-west from Breslau. It has coal-mines, bleachfields, and match factories. Population (1900), 9371.
Annual Case Mortality in Metropolitan Asylums Board's Hospitals. Before Antitoxin. After Antitoxin. Mortality Mortality Year. Year. per cent. per cent. 1890 33-55 1895 22-85 1891 30-61 1896 21-20 1892 2917-79 1897 1893 301898 15-37 1894 29-29 1899 13-95
DiU, an island and town of India, belonging to Portugal, and situated at the south extremity of the peninsula of Kathiawar. Area of district, 20 square miles. Population, 13,206. Many of the inhabitants are the well-known Banyan merchants of the East Coast of Africa and Arabia. 51 Native spirits are distilled from the palm, salt is made, 42 and fish caught.
The number of cases dealt with in the five antitoxin years was 32,835, or an average of 6567 a year, and the broad result is a reduction of mortality by more than onehalf. It is a fair inference that the treatment saves the lives of about 1000 children every year in London alone. This refers to all cases. Those which occur in the hospitals as a sequel to scarlet fever, and consequently come under treatment from the commencement, show very much more striking results. The case mortality, which was 46-8 per cent, in 1892 and 58-8 per cent, in 1893, has been reduced to 3-6 per cent, since the introduction of antitoxin. But the evidence is not from statistics alone. The beneficial effect of the treatment is equally attested by clinical observation. Dr Roux’s original account has been confirmed by a cloud of witnesses year after year. “ One may say,” he wrote, “that the appearance of most of the patients is totally different from what it used to be. The pale and leaden faces are scarcely seen in the wards; the
Dividend, the net profit periodically divisible among the proprietors of a joint-stock company in proportion to their respective holdings of its capital. Dividend is not interest, although the word dividend is frequently applied to payments of interest; and a failure to pay dividends to shareholders does not, like a failure to pay interest on borrowed money, lay a company open to being declared bankrupt. In bankruptcy a dividend is the proportionate share of the proceeds of the debtor’s estate received by a creditor. The Companies Act, 1862, provides that no dividend shall be payable except out of the profits arising from the business of the company, but, in the case of companies incorporated by special Act of Parliament for the construction of railways and other public works which cannot be completed for a considerable time, it is sometimes provided that interest may during construction be paid to the subscribers for shares out of capital. All dividends are payable in cash, while the divi-
