Show wham has by toxin ra 13 treatment by james jensen box elder high school now that probably more than two thousand of 0 our citizens have bate been inoculated with the diphtheria toxin antitoxin anti antl toxin mixture a brief survey ot of the effects ot of this treatment may be both timely and instructive many questions are being asked dally daily chief among which are the tha following where does diphtheria como come from and what are the proba bullres 0 of its ita recurrence in our co why Is antitoxin given when one contracts the disease or is exposed to it does a ease case ot of diphtheria make one immune to future attacks ilow how long should a person be quarantined for diphtheria what Is the shick test can a person contract diphtheria dip theria after r being given a prophylactic treatment of toxin anti toxin mixture this article will attempt to t 0 answer these questions in a brief manner epidemic diphtheria may appear at any time in a community although it generally makes its first ape arance in the fall of tile the year the infection is caused by the bacillus diphtheria or klebs loeffler Loei rier bacillus which Is spread directly from one to another by hand to mouth infection or indirectly through food toys dishes etc which have been very recently infected or thru milk a food in which the germ grows well in all cass the source of infection Is organisms coming from the discharges of the mouth or nose in which they are growing arid and entering the mouth or nose of the susceptible the persons harboring these germs and consequently being a source of danger are those with active cases with mild or neglected cases recent consales cents and carriers the latter form a permanent source ot of danger because they while being well fell themselves haye have active germs germa in their throats which may infect the susceptible it 11 la IS estimated eitl mated that one per cent of the population at large are carriers and they torm tact calef bou ace ot t new contagious conta gions in communities toxin and ja c toxin the lesions on the tonsils or other parts of the throat or larynx are caused by a toxin or poison produced by the germs the tae great concentration of this toxin causes intense local iffla matlon mation and as it Is absorbed by the blood alood produces widespread wide spread cellular injury of muscles nerves or other tissues in case the disease is fatal toxin is generally the direct cause of death the effects of 0 this toxin can be ae counteracted by antitoxin anti toxin toxia which acts only upon the toxin and should be given in sufficient quantity at the earliest symptoms delay is dangerous as chances for recovery are greatly diminished by delay statistics from philadelphia show a fatality or of only 11 per cent when antitoxin anti toxin was given the first day of symptoms while this increased to 56 per hundred cases it if given the second day 68 the third day and so on up to it if given the seventh day even with this information at hand the fatality in the united states is more than per year due to late administration ot of antl anti tox in or to neglect of cases by families until if is too late tor for the physician to prevent death all ali exposed members of df the family should receive injections of antitoxin anti toxin and be carefully watched during the incubation period of from two to five days when they can be properly dis infected and allowed to return to school or to work provId providing inq they have been completely isolated from the sick and their throat cultures show no diphtheria organisms the claim has been made that antitoxin occasionally causes paralysis this has no foundation as the antitoxin acts only upon the toxin and where paralysis occurs it Is due to the toxin and where the antitoxin anti toxin was given too late to ward off tills this consequence it should be ba borne in mind that while tile the immunity given by auti anti tox in III is almost immediate it is only passive and immunizes for or only a very short time th the c first injection becoming ineffectual at any time after about three weeks and subsequent injections giving still shorter periods of protection thus this Is used only as an emergency measure tor for those having h the the disease or having been exposed to it period ot of quarantine the period of varies about three fourths of 0 the cases are safe two weeks after the healing of the lesions but others may be able to spread the disease tor for a much longer period the only sate safe method is to keep the patient under quarantine until two successive throat and nasal swabs taken 24 hours apart show no diphtheria organisms Ilu manity having had diphtheria does not necessarily essa rily render a person Imm immune uneas as such immen immunity disappears dib appears after a few weeks or years permanent immunity may be acquired by treatment with toxin antitoxin mixture this treatment consists ot of definite amounts ot of a mixture ot of toxin and anti in neutralized which h I 1 the toxin has not been quite neutralized being bellig injected under the skin every week until three treatments have been given tests have shown that three such treatments render nearly all susceptible immune this method of immunizing was vas first suggested by dr theobold smith in 1907 and ince its use by clinics and practicing physicians none who were made ma de immune through its treatment have conti contracted acted the disease or shown a P positive os osiele iVle shick test this would andl c te that immunity thus acquired la Is catl lasting U g immunity developed by the injection of toxin antl anti toxin comes on slowly the treatments requiring from five weeks to six months for immunize ing consequently some ot of those who were inoculated may develop dip therla it exposed during such period if such should occur people should understand that thata his is because sufficient time has lapsed not slapped to produce immunity in othe words toxin antitoxin Is comparatively ively developing immunity but ait this immunity Is permanent while whily immunity from antitoxin anti toxin alone Is irp immediate mediate but of short duration I 1 shirt sack test ether or not a person is immune can lie e determined by the shick test consists of inoculating the skin witty a veri very small amount of diphtheria theirld toxin this will show the pre 1 I sen or absence of 0 antitoxin anti toxin in the b blood and consequently the bil bollt I 1 T of the individual ina in a negative rea ton the toxin is immediately counter I 1 ted by the antitoxin anti toxin in the blood but blit it if no such antitoxin anti antl toxin is present redi red e es i ard aed other indications readily recognized ed by the physician appear nol coall lail persons are susceptible to dight eria Ithe mother is Im immella the nu lifis rang baba groys ed a baill degree of immunity due to immunizing substances transmitted to it in the mothers milk this immunity however rapidly decreases until the s susceptibility rises to over 70 per cent among children of one to two years and then the immunity gradually rises rise a so that only about 12 to 20 per cent ot of the adult population is susceptible i this immunity I 1 is due to the formation within the body of diphtheria antitoxin anti toxin or of substances which attack diphtheria germs thus it will be seen that the inoculations that have just been becil made may not function in warding off disease at present but that nearly halt half p af the population ot of our community have provided for future health and better living conditions by making i themselves immune to future attacks of I 1 dip diphtheria li theria and by making their community that much less likely to suffer epidemics of this great plague |