Richmond dispatch. [volume] (Richmond, Va.) 1884-1903, 1895-03-21
ANTITOXlN THEORY.
iaralvss q Fair Comprehension Of Prln.
clples Of Ssrumtherapy.
Special Poison That stops the Fro
gress of Disease-Mcthods OF OBJ
tanning Antitoxsn aud Its Admin-
fstration In Diphtheria.

NEW YORK. March @.--(Special)- $50
much has appeared. not only In the medi-
sal journals but also In the daily papers.
rpon the subject OF antitoxin during the
comparatively short time Il has been in
use. that some reason must be given for
adding another article In that direction.
II 1 am mistaken in believing that, in
spite OF these numerous discussions. there
are but few members OF the profession
Ind very, very few OF the laity whose
IDEAS upon the subject are at all well
defined, then nothing is to be accom-
plshed by this article. 1t is. however.
for the latter. the intelligent and curious
layman. that this Is especially intended.
Again. most OF the articles which have
appeared have necessarily dealt with the
Investigations OF European authorities.
for the reason that until recently little
or nothing has been done in this field in
America. Since the frst OF the year.
however. the New York Health Depart
ment has carried on the work on quite an
extensive scale. md with remarkably
good results. A discussion OF their work
should be Of special interest TO the Ameri-
can reader.
AS this paper IL intended. as has been
said. for the layman. l shall endeavor to
avoid all technicalities as far as possible.
and to explain the few which must neces-
sarily be introduced.
To understand clearly the theory Of an
titoxin involves fair comprehension OF
the general principles OF serumtherapy
of which IL is but n part, and this, In turn,
demands a knowledge OF several recoS-
nlzed clinical and scientific observations.
The first Of these IL the well-known
fact that all acute infectious diseases are
self-limiting. and most of them protective
against a subsequent attack, either Tor
q brief period or for life. For example;
In scarlet-fever, ~ we can carry our pa
tient safely over the early days of the
attack, we know that the scarlet-fever. as
such, will spend its force. OF course.
serious and often fatal after results may
follow, but these are not scarlet-fever In
lection. but are due to the damage done
the system by the effects of the primary
trouble.
Many have been the attempts made In
every age to combat these diseases during
the early stages and thus cut short the
Bttack but up ~ q very recent date these
efforts have proved futile. and II IS gene
rally admitted by the profession that all
that can he done Is 10 sustain the patient
through the acute attack until the sell
limitation Of the disease is brought about
the important point. Of course, being TO
watch always for urgent symptoms ana
meet them promptly. should they arise
THROW OFF THE DISEASE.
Now. how f. the self-Iimitation Of these
diseases TO be interpreted? In spite OF the
continued presence OF an infection ca
pable Of communicating the disease to
another susceptible individual, how does
the patient himself throw off the disease!
Upon the-pxplanation as at present ac-
Cepied rests the foundation of antitoxin
therapy. II has been conclusively de-
Ynonstrated that an individual, in passing
through the acute stage Of an infectious
disease. develops In the blood certain
substance which is an active antagonist
10 the special poison Of that disease, and
which, after its presence has been thor
oughly established. makes a further pro-
gress OF the original trouble impossible
The individual then possesses immunity,
or. as ii is now commonly expressed, Is
immune against that disease. II is fur
Their found that this immunity can be
conferred upon a previously susceptible
individual by the injection OF blood from
the immuniZed individual.
The poisonous products elaborated by
the growth of the germs OF the infec-
tious diseases are termed toxins, while
the antagonistic protective principle for
each is an ant-toxin. Thus II will be
seen that antitoXin is a generic term,
although at present applied almost ex-
Cllsyely 10 the antitoXin of diphtheria.
II these preliminary points are wei
understood by the reader. he is now pre-
pared TO appreciate a description OF the
methods actually employed in obtaining
antitoxin and the theory OF It's admin
istration in diphtheria.
In order TO thoroughly understand the
work at present carried on in this field
in the city OF New York by the Health
, department there are two Institutions
the laboratory OF the Health Department
and the Willard Parker Hospital for Con-
tagious Diseases-at which we must spend
some time. and third-the New York
College for Veterinary Surgeons-whlch
must be at least visited.
TESTING UPON ANIMALS.
propose. In the present article briefly
20 outline the work done at the laboratory
and at the Veterinary College. describing
the methods OF obtaining the antitoXn
and testing II upon animals. In a subse-
quent paper I shall speak Of the pract-
cal results Of the treatment as seen at
the Willard Parker Hospital.
There are siXty-two horses at present
employed by the New York Health De-
partment for antitoxin purposes. Sixteen
OF these are at the College for Veterinary
Surgeons, No. 15i east Fifty-seventh
street.
II Is found that thoroughbreds are not
best adapted for this purpose on account
OF their highly-nervous temperaments.
on the other hand the greatest care must
be exercised In selecting perfectly healthy
horses Of strong constitution. 1t is espe-
clally important that the disease known
ax pionh.rC IL
ton is always absolutely decided. These
animals are given every attention. and
are gotten In the best possible condition
before the Injection OF the toxins is COM
menced. The toxins are obtained from
and old v!rulent bouillon culture of the
kiebs-Loefiler bacillus. which IS now
recognized as the germ of true diphthe-
ria. The living bacteria in this are first
killed by the addition of some germicide
usually carbolic acid. and then entirely
gotten rid OF by means of filtration. The
more or less clear fluid thus obtained has
In solution the toxins or pOisonsous pro-
ducts which cause the general symptoms
OF diphtheria in the human or other sub
Ject. The power OF this Is tested by a
series Of injections into guinea-pigs
which are exceedingly susceptible 10 the
poison Of the disease. and the minimum
dose determined which will certainly
cause the death OF the animal within a
Few days That at present employed by
the New York Health Department Is Of
such u strength that one-tenth OF a cubic
centimetre about one and one-half drops
IS fatal dose and hereafter when re-
IerriDg 10 toxins IL will be understood
that toxins OF this standard are meant.
To obtain IL Of proper strength and in
sufficient quantities requires a good many
weeks laboratory work.
FIFTEEN DROPS.
Having secured this and the horses
being in good condition. the first injection
Is given. usually one cubic centimetre
(ifteen drops). which, as we have seen,
Il ten times the fatal dose for a guinea
pig The operation itse.f is painless, and
the horse usually makes no objection 10
the quick insertion OF the needle and the
injection OF the fluid. On the following
day there Is rise OF temperature. and
possibly more or less restlessness and loss
OF appetite; but otherwise the animal
suffers no inconvenience. A few days
later the injection is repeated. This time
probably two cubic centinfetres are given
a chart is kept for each horse. and not
are entered upon this as carefully as for
patient under hospital treatment. Its
temperature. pulse. and respiration are
recorded twice a day. Its general condi-
ton. weight state Of appetite. and Sc
cretiOns. and. Of course. the time, amount
and strength Of the toxin injections are