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The Origin and Progress
Os Diphtheria Prevention
The following article is by Dr. Wil
liam H. Park, Expert in bacteriology,
public health and hygeine; Director
of the Bureau of Laboratories, De
partment of Health, City of New
York; the greatest authority in the
world on diphtheria, who has lived
for years in our most populous city,
where he has observed and studied
tens of thousands of cases for the
purpose of learning the exact truth
concerning diphtheria. Every one
should read and reflect on each sen
tence of his article.
Diphtheria is no longer the terrible
scourge of infancy and childhood that
it was before the discovery of anti
toxin, but it still destroys more lives
than any other of the contagions dis
eases. Last year fifteen thousand lit
tle children died from it in the United
States and one hundred and forty
thousand were sick. The tragedy _is
that this bodily suffering of the babies
and little children were entirely un
necessary for we have a nearly cer
tain cure and an absolute preventive.
Diphtheria is caused by a germ that
lodges in the mucous membrane of
the nose or throat or windpipe. Once
located there, the geryis increase in
number rapidly and nffjjke a powerful
nois.-n, called toxin, which injures the
lining of the throat and so produces
the ‘‘gray membrane.” Diphtheria is
insidious in its onset. The child is not
very ill at first. There is some sore
throat and perhaps a little hoarse
ness. There is a slight fever and a
few grayish spots on the tonsils. If
the disease continues unchecked ai'd
the case does badly, the gray mem
brane increases. If the membrane is in
the windpipe, the child may strangle.
At any time heart failure may occur.
Now suppose this were your child,
what could you do to save it?
We will imagine that your child
■complains of very sore throat, little
grayish spots are c < en on the tor:-:lr.
or he becomes croupy. If there is any
-suspicion of diphtheria, ho time should
be lost in summoning a physician. If
«n examination the doctor suspects
the case to be diphtheria, he will give
the child a dose of an antidote called
antitoxin. Antitoxin given early will
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check the disease and give the child a
better chance to win the struggle.
I have seen a number of tragic
cases where, because of delay in sum
morning a physician or a refusal to
permit the prompt use of antitoxin,
a child’s death occurred.
No well-informed parent will blame
a physician who gives a dose of anti
toxin in a case which later proves
not to have been diphtheria. No harm
is done by injection of antitoxin but
death may follow the withholding of
it until the physician is certain of his
diagnosis.
Antitoxin to be effective must be
injected hypodermically—-that is, in
to the tissues—by a hollow needle at
tached to a syringe. From the tissues
the antitoxin slowly penetrates into
the blood and from the blood it passes
through the walls of the smallest
blood vessels to all parts of the body.
In bad cases we inject antitoxin di
rectly into the blood, thus avoiding
the slowness of absorption. Once ab
sorbed, antitoxin remains in the
blood. The best practise now is to give
a sufficient dose at the earliest pos
sible moment and not to repeat it.
It has been found that of the in
fants and children who receive anti
toxin on the first day of the disease,
ninety-seven per cent recover; of
those to whom it is given on the sec
ond day of the disease, ninety per
cent recover, and of those who receive
antitoxin on the third day only eigh
ty-five per cent recover.
Nearly thirty years ago, before an
titoxin was accepted as a curative
agent by physicians in general, I had
the opportunity of watching two
groups of children, one receiving an
titoxin, the other not. It was heart
rending to see some of the children
who did not get the antitoxin grow
worse day by day and die, while'oth
ers who had been just as ill recovered
after receiving the antitoxin.
Protection In Case of Exposure
If children have been exposed to
diphtheria, how can we protect them
from developing it?
Wonderful as are the results of an
titoxin when given early in a case of
diphtheria, its value is even greater
as a preventive. A small injection of
Walker bounty Messenger, January 11, 1924.
antitoxin given before or after ex
posure will absolutely protect a child
; for a period of two weeks and prob
able three weeks.
Can a mother or nurse, in the ab
sence of a physician, administer an
titoxin ?
Yes it would be wise, if a physician
can not be procured promptly, to
, have a nurse or' the mother give the
I antitoxin. The nurse or mother should
cleanse the skin over the back of the
arm of the patient with soap and wa
ter and then, if possible, paint the
spot with iodine; then inject the an
toxin under the skin. Antitoxin is
now supplied in a syringe container
and is ready to inject. Directions ac
company each package. Parents who
live far away from doctors and drug
stores should keep a supply of anti
toxin. It can be sent through the mail
or by express and can be stored for
two years. Many States supply free
antitoxin to physicians.
The Schick Test—For many years
it has been known that a certain pro
portion of children and adults in any
community are immune to diphtheria
because of the possession of natural
antitoxin. Dr. Schick of Vienna dis
covered a very simple method of find
ing out which children are susceptible
to diphtheria and which are not. This
method is called the Schick test. He
found that if a tiny amount of diph
theria toxin were inserted by means
of a fine needle into the skin of a sus
ceptible child, the toxin would meet
no natural antitoxin and would act as
an irritant, causing a red spot the
size of a dime to appear. If no spot
developed within three days, it was
proof that the child was immune.
The Schick test is liable to give us
much interesting and valuable infor
mation about immunity at different
ages and under different conditions.
'For instance, about fifty per cent of
adults living in the country are im
mune and about eghty five per cent
of those living in cities. If a mother
is immune, her infant is immune at
birth and. for some six or twelve
months after birth. The presence of
this transferred antitoxin and com
parative isolation of babies are the
reasons why so few of them develop
diphtheria. Between the ages of one
and three years nearly all babies are
shown by the Schick test to have no
antitoxin. That is the most dangerous
period of their lives in regard to
diphtheria. Year by year as they
grow older a greater and greater per
centage of them develop their own an
titoxin and diphtheria becomes grad
ually less of a menace. Nevertheless,
one half of the children remain sus
ceptible and need protection.
Lasting protection can now be giv
en to children by toxin-antitoxin with
out subjecting them to danger or
annoyance.
The wonderful thing about the ad
dition of antitoxin to toxin is that,
while it robs the toxin in the mixture
of its poisonous and irritating quali
ties it leaves the toxin the power
to stimulate in human beings an an
tidote and so gives protection to those
who receive an injection.
The first injections of the toxin-an
titoxin in children were given by Von
Behring in 1913. They were begun by
us in New York a few months later.
The great War prevented Von Beh
ring’s continuing the investigation,
but in New York the work has pro
gressed steadily.
We knew from our animal experi
ments that the injections would pro
tec* the children, but we were igno
rant of how long the protection would
last. If it lasted only a year or two,
it would hardly be practical to use the
injections as a public health measure.
We planned at the beginning to set
tle this important point.
Our first observations were made
on several thousand little children
who we expected to remain in institu
tions for a number of years. We gave
those who were susceptible three in
jections of this protective mixture.
In none of these children did any
harmful results develop. In some, in
deed, a slight temporary soreness at
the point of injection lasted for two
or three days. We found that about
85 per cent of the children injected
became absolutely immune to diph
theria. The remainder responded to
additional treatment. Year by year,
we have retested these children and
we find that with very few excep
tions they have remained completely
immune. These results were so satis
factory that the school and health
authorities decided to offer this pro
tection against diphtheria to children
attending school.
The school work in New York was
begun in a small way six years ago
and has so developed that about half
a million of the million school
children have received the Schick test
and those not immune the protective
treatment also. Many thousands of
the younger children have been treat
ed in their homes by their family doc
tors or in baby health stations by the
health department physicians. The re
sults have been so favorable that the
health authorities of Boston, Chicago,
Baltimore, Philadelphia and many
other cities are now urging the use of
this new method. When we began this
work in 1917, the deaths from diph
theria among children in New York
City numbered nearly 1200 a year.
During the past year, there b»•-«
only n little over five hund’-ed.
Now that we ha e at hard {i<
com. irstively simp>e yet adequate
of prevention. parin'*
chor <? whether or n< + the;- '■hri'^ l •m I
are ‘ -im the nsl- r.' •• t,
thor ' We urge *hat you + nk° vour
chih. n who are over one year of age
to ".'v family physician at once and
ha * '-m protected by means of the
to- itoxiii treatment. If the test
an ment are being given at
s'-’ d your children bring home a
cV - sking you to permit the
h- ’ -nr, protect your
ch' . ■ hope that, unless your
ow r hns already done this
you 'll give your consent. You will
prof vour own children and will
prev Tit them from being a source at
contagion to others.
(Nuit: Ur. I'lerte i. president of
the Invalids’ Hotel, Buffalo, N. Y., to
which for SO years past chronic suf
ferers have been coining for special
ised treatment from all over the U. S
A., Canada and foreign lands.)
Will Undo Much Evil
By Dr. V. M. Pierce
Knowing the vast amount of
harm wrought by diseases of the
kidneys, and having had opportun
ity to observe the analyses and the
successful methods of treatment iu
thousands of cases of kidney trouble
at the Invalids' Hotel, 1 have re
cently given to the public the latest
and perhaps most important of the
Dr. Pierce home remedies, "An
uric" (anti - urio - acid) Tablets,
which 1 now recommend to those
who suffer with kidney backache,
Irregularity of urination and the
pains and disturbances that come
Irom excess of uric acid in the blood.
"An-uric” can be had now at all
the drug stores. The mere drinking
of a cup of hot water each morning
and a little "An-uric” before every
meal should bring remarkably
quick improvement. You may have
kidney trouble and not know it.
The danger signals to be watched
for and quickly heeded are back
ache, depression, aches, pains,
heaviness, drowsiness, dizziness,
Irritability, headaches, chilliness,
rheumatic twinges, swollen joints,
gout.
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CHATTANOOGA VALLEY
Mrs. John Howard passed away at
her home last Tfesday after suffer
ing several days with pneumonia.
Funeral services at Chattanooga Val
ley church Thursday, conducted by
Bro. Thomas. The family have the
sympathy of the entire community in
the loss of a good wife and mother.
There will be preaching service
Sunday at 11 o’clock by Bro. Lord.
He has been elected pastor for this
year. Let's everybody come out and
join hearts and hands in brother love
and Christian fellowship.
I cannot refrain from writing a
word in answer to Rambler although
I really think he is starting some
thing only “to see the fur fly.
He fairly makes my blood boil and
should not be allowed to run at large!
He defends himself or rather his sex
by knocking the opposite. Why didn’t
you tell us that women are vain, de
ceitful and” treacherous ? I claim they
are not. As a race women are most
noble, aff<*tionate and loyal. Truly
there are some women that art both
treacherous and deceitful and we de
plore the fact quite as much as he.
But happily these women are in the
minority by far, especially when seri
ous matters are involved. Take, for
example, Rambler, the wildcat specu
lations and swindles which we read
so much about. Are they represented
by men or women ?
You admit you men are all subject
to wrong and do wrong. Thats a stum
bling block for you. You take it for
granted, like measles and mumps,
in childhood, that men must do wrong
because it has aKvays been done, and
so passes comparatively unnoticed.
But if a woman or girl oversteps
the boundary line—What? Oh, Mer
ciful Horrors! I told you so; and so
on to the end of time.
Who was it used deceit and betray
ed our Saviour or Christ? A man, of
course. Who denied Him 3 times? A
man. Who started the worst war the
world has ever known ? A man and
his men. Did they use deceit? Surely
and plenty of it. Who sneaked up and
killed several of our Presidents?
Men. Now ’fess up Rambler. You
know you have met women who ap
parently were cold and hard, but if
you allowed yourself to become better
acquainted with them, you would find
them really lovabV characters. But
while in contact with the cold, hard
world, they find it essential to partly
disguise their softer or as you would
call it their weaker traits. We feel
d"enly sorry for ‘he Rambler to
think you would deliberately enter
tain fah a mis’-ken idea of our
sen, when you could so easily be dis
illusioned. Don’t you realize you. are
missing the second best part of your
life?
t-e agre"' many young girls
ri' 1 l-now, as you and Ido how de
■'''■ful men are and quite naturally
believe them so why shouldn’t they
be vain? Wouldn’t you be vain if
■••ome young beauty raved about how
hendsome you danced and how terri-
Vy sweet you were with that little
curl over your left eyebrow?
Poor old Rambler, I really believe
you appeared just to see what kind of
a hornet’s nest you could stir up, but
be careful sonny, you cannot play
with bees without getting stung. Pos
sibly it would pay you not fco ramble i
too far from home, SUSAN. '
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