Americus times-recorder. [volume] (Americus, Ga.) 1891-current, 1913-07-10
WHERE ANTITOXIN FAILS
Writer Explains Limitation
of Diphtheria Serum
From the Journal of the American
Medical Association.)

SA-~ 'SN~N~
Medical Association.)
While the curative treatment OF
diphtheria with diptheria antitoxir
constitutes one of the great triumphs
of modern medicine, our present meth
DDS of prevention of diphtheria are adj
mittedly far from satisfactory. Diph-
liberia antitoXin acts by neutralizing
the toxin which causes the principal
effects of infection with diptheria bac-
I'LL and in the meantime the bacilli are
destroyed more or less successful by
the usual means of defense against in
vading bacteria. But the use of diph-
iberia antitoXin for preventive pur
pose is not a practical success be-
cause the antitoXin is eliminated too
rapidly, as it is part and parcel of
the proteins of foreign serum which
are soon destroyed when introduced
into the human body. For this reason
the passive immunity from diphtheria
antitoXin in horse serum lasts from
two to three weeks only Under or
binary conditions the frequent injec-
ton of antitoXin serum for this pur-
pose is not practicable for several and
obvious reasons"
The fundamental principle on which
Behring bases his new method of Sc
curing more permanent immunity is
the active immuniZation of the human
body itself that is, the elaboration of
diphtneria antitoXin by the body of the
person inoculated This is to be &C
complished by the injection Of mix
lures of diphtheria toxin and antitoXin
that are almost neutral, and, con-
sequently, produce no toxic effects Of
any Importance, there being present a
mineral excess only of toxin 1t has
long been known that more or less
balanced mixtures of this kind pro-
duce immunity in animals, and in 1907
Theobald Smith suggested that t
might be possible to employ this meth
cd to produce Immunity in man. Sub
sequently, Smith studied the effects of
injections of neutral mixtures in
guinea pigs and horses and again
pointed out the applicability of the
method to human beings.
Now Behring and his collaborators
find that the injection of toxin-anti-
toxin mixtures in human beings does
result in an accumulation in the blood
of antitoXin sometimes very large and
persisting for at least several weeks
This may be accomplished without any
unfavorable results. Behring believes
that the immunity so produced is
much more durable than the passive
immunity from anti-diphtheria horse
serum, and also that the serum from
human beings actively immunized may
be used to good advantage for curative
and preventive purposes, because the
antitoxin will remain much longer
when introduced in homologouS
serum.
This use of human serum has prac-
teal limitations, however, and the
danger of transfer of other infectious
diseases must always be born in mind,
Unquestionably long step in advance
in the method of prevention of diph-
iberia has been taken. 1t is doubtful
however, whether the ideal method
has been evolved. because the proce-
dure discussed probably does not in
clude any factors whereby the toler-
ance of the diphtheria bacillus by the
organism is prevented A person
might possess a high degree of active
immunity to diphtheria toxin and yet
harbor virulent bacillf in his threat
which he would be the means of dis
seminating.
In order to diminish as much as pos
sible the chances for the bacilli to es-
tablish themselves in this manner, it
would seem desirable to increase also
the active resistance of the body to. j
the diphtheria germ, and possibly this
could be accomplished by the injection