The St. Louis Republic., 1901-11-19

Of diphtheria antitoxin units. while the non
. toxic sera df August "a contain smaller num-
Der of these units. See table is
VII.
In order TO determine the toxic strength OF the
sorum which we had found contained the tetanus
toxin, a number OF animals were inoculated
with varying quantities OF this serum. Thus IL
found that one-tenth OF a cubic centimeter
ccrtained the mininal fatal dose for a guinea
pig of 800 grams weight See table IL From
this. very interesting deductions can be drawn
as TO the smallest amount OF tetanus toxin fatal
q human being. IL consider IS ldlos the
average weight OF the children that died from
tetarus and that 10 c. C of the serum proved
fatal in all cases excepting those in which te-
tan us artitoNin administered early enough
an approximate computation can be made That
the dose Of 10 c. c. Of the serum contained not
much more lees than the single fatal dose Of
tstsnus toxin is illustrated by the gradual in
crease in the severity Of the symptoms in the
Ihee Goldsteln cases. While the youngest chiId.
- years old. exhibited the typical picture Of
tetahus the mid lie one, II years old, showed tn.
syfnitt ms less aggravated. and the Oldest child
~ years old. showed only Incomplete prIsmus
III, then. We reduce the amount Of toxin necer-
sary 10 XIII guinea rig and. on the other hand,
that necessary 10 prove fatal TO a human helms,
OF fifty pounds weight find the relations
OF their susceptibility is i:os3. or. If we take the
horse, with double the susceptibility OF the
guinea pig We obtain for the human being a sus-
cepuoility Of about half that II the horse
CONCLUSIONS.
As the result OF our Investigations we draw
the following conclusions:
The diphtheria antitoxin prepared by the Health
Department Of the city Of st. Louis and dated
september 80. and some Of the serum dated
August "a. was the cause of the recent deaths
from tetanus in the cases where this antitoxin
used.
This antitoxin was sterile but contained n.
amount
There were two different sera. issued under
the date of August 2i-one portion not contain
ing the tetanus toxin and characterized by other
nf1,a gr,oa.
toxin and was Identical with the serum bearin.
the date of September %.
The most important result have arrived at
ls the positive demonstration that the toxic 80
rum dated August "a and that dated Septernher
u are Identical From this We conclude that the
serum Of September % issued without having
been tested by the proper methods. and that a
part OF it was filled into bottles bearing the date
OF August a. or was furnished with labels hav-
Ing previously been stamped with this date.
w are justified In drawing this conclusion from
two observations: First that the serum of Sep
tenber 30 was issued before there was time 10
nave performed the simple tests necessary TO de-
termine the antit0xic potency OF the serum. Sec
ond. In the same way serum dated October %
came into our possession November l. This
serum had been issued 10 the Coroner. II is OBJ
Nious from this that animal experiments
could have been made with this antitoxin, As
ms was the case with the serum Of October %.
II IS the natural Inference that the OF
september 30 was issued in the same way
isted in the horse Jim from August "a 10 Sep
tember 90. well-authenticated cases have
been reported in which the incubation period ex-
tended over seven days in experiments directed
to test this point The period OF incubation can
not be determined from clinical observations.
from the nature Of the case.
1t therefore follows from this that the serum
drawn on August "a was free from tetanus but
that the serum of September % was drawn during
the period OF incubation and had it been tested
upon animals ii must necessarily have revealed
Its toxic properties.
From the foregoing facts we forced to con-
clude that the dphtheria antitoxin prepared by
The City Health Department has been issued be-
fore IL was possible TO have obtained results
from the absolutely necessary tests. Had these
tests been performed the results upon animals
would have been such that the serum would not
nave been dispensed. and the cases Of tetanu.
forming the basis OF this report could not have
resulted.
tSigned)
DOCTOR c. FTSCH.
tSigned)
f. c. WALDEN