Evening star., 1896-11-30
USE OF ANTI-TOXIN
DR.. Adams Regards It as Invaluable
in Diphtheria Cases.
WHAT is CLAIMED FOR SERUM
1t Has Already Reduced the Death
Rate Enormously.
A CAREFUL INVESTIG ALTON
A CAREFUL INVESTIG ALTON

DIR. 5. s Adams. the attending physician
at the Chidren's Hospital and the Found
ling Hospital, has had considerable per-
sonal experience in the use of diphtheria
anti-toxin, and has made special investl-
cations into the question of it's value as a
remedy for that dread disease. When
asked by Star reporter this morning to
give his views on the subject DR. Adams
said:
In view OF the prevalence of dipht theria
in this city at this time, and the great
harm that may result from the failure to
use what / believe to be valuable rem
edy IN its treatment, 1 feel it my duty to
waive all opposition that 1 may have to
interviews for publication.
In the first place I may say that until
the Introduction of anti-toxin physicians
who make specially of pedatrics haii
practically discarded all so-called general
treatment and We're compelled to rely
solely upon rest, diet and stimulants. AS
proof CT the value of anti-toXin it may
be said that not long since a case of diph-
iberia occurred in one of the largest wards
in the Children's Hospital. The child was
given the injection of anti-toxin for cura-
tive purposes and all the others were given
the immuniZing dose. No other cases
have occurred Before the use of this
remedy We were accustomed to refuse to
admit new patients whenever a case
of this sort was in the institution. Now,
however. we have no dread in admitting
new patients. The history of the insti-
tuition will show, further, that prior to
the use of anti-toxin this disease was never
limited to one case, as has been done IN
two instances. In the Childrens Hospital
of Boston DIR. F. Gordon Morrill, clearly
demonstrated the value of the preventive
injeC ton of anti-toxin. He would inject
the child having diphtheria with the full
dose. and all the other children in the
family with the preventive dose. All OF
these children We're now admitted to the
ward for diphtheria cases, and, in spite OF
the fact that they mingled with those
having the most malignant type, not child
so protected had any symptoms of the dis
ease. In this institution also new patients
are now admitted in spite of diphtheria,
while prior to the use of anti-toxin the
doors We're closed to new patients
DR. Adams was asked whether there had
by one of the leading medical societies of
the country
4 Scientific investigation.
Yes" he said. there has been such an
investigation by the American Pediatrc
Society, a body of medical men who devote
much of their time to the study of the dis
eases of children, the results of which were
May. 1895. The committee in charge of
the matter consisted of Drs. l.. Emmett
Holt, w. P. Northup. JOS. O'Dwyer of New
York city and myself
DIR. Joseph Winters of New York has
been frequently quoted one of the bit
terest opponents of the use of anti-toxin.
Is the position taken by him supported by
the results of this investigation?
DIR. Winters is a member of the So
ciety referred to, and a cultivated gentle
man, but his position in this matter is en-
tirely unique, in that be is the only MEM
Der of the society who diScreditS the value
of the remedy. The results of the investi-
CATION of the committee were directly at
variance with the position taken by him.
DR.. Winters experience. so far as is known,
has been confined chiefly to the Willard
Parker HosDital of New York. Now let
us see what the committee have done with
regard to hospital cases The views of the
committee in reference to such cases are
shown in the very beginning of their re-
port and by the method adopted in their
investigation They say:
There are very few hospitals that re-
ceive dlphtheria patients, and the condi-
tions under which patients are admitted TO
hospitals and the surroundings while there
are so different from those OF private prac-
tice that the measure of success in hos
pitaI cases cannot be taken as index of
the results which have been obtained this
side OF the Atlantic with the new treat
ment. In order therefore, TO obtain ex
preston of opinion from American phySi-
clans as to the serum treatment. after
what had been. with most of them, their
first years experience. a circular letter
was prepared a3G issued by the committee
early In April. This was distributed through
the members of the society as widely as
could be done during the time allowed. An
attempt was made to reach many physi-
clans as possible who had had experience
with the remedy
'.Nhat was the extent of this investiga-
tom
Here again 1 quote the report of the
committee:
".The first surprise of the committee was
in learning how very widely the serum
treatment had been employed. especially in
the eastern and m.d-westcrn states. Re
ports were returned from 90 physicians,
with 3,G1S cases. OF these. 2ii cases have
been excluded from our statistical tables.
These were cases in which the disease
said to have been confined to the tonsils.
and the diagosis not confirmed by culture,
and therefore open to question. few
cases were reported in such doubtful terms
as to leave the diagnosis uncertain. The
figures herewith given are, therefore. made
ip from cases in which the diagnosis was
confirmed by culture embracing about
two-thirtlS of the whole nuInber) and 9TH
ers giving pretty clear evidence of dph-
iberia, either in the fact that they had
been contracted from other undoubted
cs:sas. or where the membrane had invaded
other parts besides the tonSilS, such the
palate, pharynx, nose or larynX.
\ Sure Test.
rs this diphtheria, as has been alleged,
of rlilder type than formerly prevailed.
and does 1t consist, as has been alleged, OF
such cases as used TO be diagnosed as fol-
ocular tonsilitis and sore throat?
THE committee which conducted the in
yeStigatOn referred to state that n the
general opinion of the reporters, the type
of diphtheria during the past year has not
differed materially from that seen in pre-
vious years, so that ii has been average
diphtheria which has been treated. If
there IS any difference in the severity of the
eases included in these reports from those
of average diphtheria it is that they en-
brace j rather larger proportion of very
bad cases than usually brought to-
gether in statistics. The cases according
to the extent of the membrane are grouped
as follows: In J.r' the tonSIls alone are in
volved in .;;9I the tonsils and pharynX. the
tonSiis and nose, the pharynX and nose, or
all three are affected. In 1,25G cases the
larynx was affected. either alone with
the tonsils, pharynX, and nose, one or all.
1t will. however, be remembered that ton
silar cases not confirmed by culture have
not been Included.
Even, however, were the type Of the
disease milder than formerly, the conclu-
sions would not be affected thereby, for
the cases studied in which anti-toxin was
used occurred during the same period as
the cases treated without its use. AS a
matter of fact, the cases in which anti
toxin is not used seem, a rule, to be of
milder type than those in which 1t is
given: the remedy. being a new one to
many physicians. they are inclined to ad-
here &c old methods until they have been