The herald., 1896-06-03


induced us to formulate and propose a
plan to overcome all these hindrances-
believing IL had passed the experimental
stage-and thus place q remedy, which
promised so much for the dread disease,
within reach of all and deprived of the
many uncertainties above mentioned.
We proposed to take the business out
of the hands of the trade and place it in
the hands of the California state board
of health: and at the January, 1895,
meeting at Sacramento our plan was
adopted and bill prepared and present.
ed to the state legislature, then near the
end OF the session. asking for an appro-
priation of $4,000 to procure or prepare
diphtheria anti-toxine for free distribu-
tion throughout the state for the next
two years, under the direction of the
state board of health. That the bill
passed Immediately attests the intelli-
sence and humane character of the last
legislature. The bill was so worded that
the scientific departments of the
state university at Berkeley but
by the time we were in shape
to use the appropriation, other
plants or laboratories in this country
began the preparation of the remedy,
and although we have a department of
biology and also a veterinary depart
ment and apparatus, yet we could pur-
chase it of reliable laboratories cheaper
than we could prepare 1t.
Thus the state of California was the
first in the union to take such advanced
grounds on this important matter.
We divided the state into five dis
tricts for convenience of distribution,
and established a depot of supply in each
district, which is in full charge of the
resident member of the state board: and
to facilitate its use we purchased a dozen
antitoxine syringes of the latest pattern
and placed several at the disposal of
each depot for the benefit of those who
had no suitable syringe for antitoxine.
Thus We have placed, gratis, reliable an
titoxine at the disposal of every licensed
physician of any school, and only re-
quire clinical returns in cases treated,
that we may have statistics from our
own physicians in our own state.
The serum which is, from its nature.
perishable If not properly handled can
be kept almost Indefinitely in cold stor-
age, where we have been keeping it for
more than a year, during which time we
several times ran out of the fresh pro-
duct and then used up the old stock
which had been prepared for many
months. with good results
In looking backward over more than
a years trial of our plan. we are more
than satisfied with the results. Much
of the prejudice against it has subsided,
and physicians of all schools are using
1t. But.as yet. unfortunately, there are
no facilities or provisions for bacteriO-
logical examinations by the state or by
municipalities in California. We also
regret to say that, although we have
given this matter much time. and have
spared no pains in giving detailed in
structions in regard to antitoXine and
it's technique (and the board has insist
ed on clinical reportS). we have been
disappointed that physicians have been
so tardy in making prompt returns in
so important a matter at this time.
The stronger preparations of antitox-
to- 1,A hos ND n %
tive dose is (when administered earlyl
10000 units behring's standard). and in
severe cases, or adults, or advanced
cases, or Group, 1900 units should be
given, and these doses may be repeated
every twelve to tWenty-four hours till
5000 to 5000 units are given in single
case Two hundred units is an average
immunizing dose. The usual antiseptic
precautions should be observed and no
more care is required in the administra-
ton of anttoXine than in other up to
date" procedures in medicine and sur
gerry. The injection should be made un-
der the skin in the cellular tissue, ana
not in the muscular tissue, and over the
chest sides or back, according to cir
cumstances; but, the dose being large.
there is often considerable reaction and
soreness at the site of the injection,
which interferes with movements or
handling for a day or two. For lmmun-
izing an ordinary hypodermic syringe
may be used, and the deltoid region is
! best, as it ordinarily Is, Tor all injections
| for any purpose. :,
| There has been expended in the dis
| tribution of antitoxine throughout the
| state, Sl451.6 60, and we have about Sl00
| worth of antitoXine on hand at the 1Ve
| stations The Los Angeles depot has
distributed 2S4 bottles of diphtherla an
titoXine-11 Walls of the German prep
aration and '267 from Parke, Davis IL
Co., all of 10 &C. to the VIAL Sc Walls OF
500 units; 125 of 1000 units; and 73 Walls
of 1900 units (Behring's standard. We
have received clinical reports from more
than fifty physicians who nave used
antitoXine in California-most of these
from the Los Angeles district, where
diphtheria antitoXine is more generally
used than in any section of the state.
Although we had hoped to be able to
give complete statistics, yet these re-
ports indicate the great value of the
| remedy, as it has been uniformly sue
cessful for immunizing, and there have
| been no deaths where antitoXine was
used within twenty-four or thirty-siX
| hours, and the three or four deaths re-
! ported have occurred in cases where the
antitoXine was not used for four or five
days, to even ten days A single dose
was given in a large majority of cases.
| and if given early it is sufficient; but
| | have given 5000 units in one case. where
| the disease had been running five days,
| with good recovery, excepting slight
| paralysis, which soon disappeared
| without treatment In many cases the
| use of antitoXine is followed within a
| week with urticaria, which is uncom-
! Portable. but soon subsidies, even with
| out treatment.
In considerable personal experience
with, and observation of, fits. use,
| have seen no accidents or bad results
! from the use of diphtheria antitoxine
| and would advise its universal use both
| for immunizing and for treatment.
Inquiry in the city health office shows
| that there are at present only four mild
| cases OF diphtheria in the city. Antitox-
Inc is used in treating them.
AN INSANE FRESHMAN