The Mt. Sterling advocate. (Mt. Sterling, Ky.) 1890-current, 1920-11-18

SUGGESTIONS FOR ATTEND
ING PHYSICIANS: Prompt ana
early diagnosis in all suspected
cases. In doubtful cases, antitoxin
should be given at once, without
waiting for a report from the labor
atory.
The health officer Of each county
is provided with mailing cases con-
tanning sterilized swabs which can be
obtained by any physician upon re-
quest, or they will be mailed direct
to any physician who writes for them
to the State Board Of Health, No.
$50 w. Main street, Louisville, KY,
or to the Public Health Laboratories,
Lexington, Ky. The results Of the
examination will be promptly mailed,
or, on request, be telegraphed or tel
ephoned, at the expense Of those in
terested.
In mild cases on the FIRST day OF
the disease 5000 units of antitoxin
will be generally sufficient. After the
first day, 10000 units; in usual ana
laryngeal cases, never give less than
10000 units, for the absorption of
diphtheria toxin is very rapid and
great in these regions. Double the
initial dose in hours if the condi-
ton is not improved. Intravenous ad-
ministration in severe cases is ad-
vised. Antitoxin is not dangerous
it is given to get results, so do not
hesitate to give large doses.
On the first visit instruct the
mother or nurse regarding proper
disposal of discharges from the nose
and throat.
Cultures should also be taken
from the threats of the well members
of the family. Those who are found
to be "carriers" should be isolated
and treated. Very young children
should be given an immunizing dose
of diphtheria antitoxin, i. e., 10000
units. The immunity lasts about
three weeks.
When diagnosis Of diphtheria has
been made, telephone at once to the
County Health Officer and send il
an official report within "a hours
Cultures for release from quaran'
tine should be taken from the nose
and throat, not earlier than the 24tl
day of the disease. When two cul.
lures, which are taken "a hour:
apart, are reported negative, the is.
olation period may be termined by
the Health Officer. In a small per
centage of cases, the germs of diph
liberia persist for many weeks o,
months.
THE SCHICK TEST: The Schicl
Test will determine those who ar,
not immune, and these may be mad,
permanently immune by the use o.
toxin antitoxin mixture.
To perform the Schick Test dos'
of diphtheria toxin is injected be
tween the layers Of the skin of tn,
arm. A positive reaction appears il
"a to 4S hours as a distinctly cir
cumscribed area of redness, anC
slight infiltration which measures
to 2.5 centimeters in diamater. The
redness increases in intensity dur
ing the next three or four days, per-
sists for another week, and on fad
ing gradually gives place to a brown
ish fermentation, which always
shows superficial scaling.
1t appears earlier, is less circum-
scribed, and usually disappears in
from three to four days. 1t is char
acterized by a central area of red
ness of varying size, surrounded by
a secondary areola. On fading il
leaves only family augmented area
which soon becomes invisible. The
practical value Of the Schick Test
outside of schools, hospitals and in
stitutional work has not received the
attention it deserves by many gen