Publisher's Synopsis
Excerpt from Albany Medical Annals, Vol. 40: Journal of the Alumni Association of the Albany Medical College; July, 1919
In recent work in the army camps they found only about one in ten Of positive culture showed virulence so that not all carriers are dangerous. If you take a culture in a community when diphtheria is present, you will find that the ratio is considerably larger. Five or six per cent are positive, especially in camps and institutions. It is not always the finding Of the morphological germ of diphtheria which gives us such great concern. Then another problem which we have to contend With is reluctancy in giving antitoxin early. Schick has shown us why we should give antitoxin early. He has shown us that antitoxin has 'no value after the toxin of the diphtheria has entered into the cell tissues. The only way by which we can expect the antitoxin to do any good is to catch the toxin while it is still in the blood cur rent. \f\'e must give antitoxin in the early period otherwise much damage will be produced. I do not know how it is with you, but we have Often heard it said that you must continue to give anti toxin so long as the symptoms are bad. If you give a single dose Of antitoxin and give a large enough dose at one time, there is no use Of giving any more at all. The only time you should give more is when you are in doubt as to whether you have given enough in the first dose. Give sufficient dose at the earliest pos sible moment.
The question comes up as to the method of administration Of antitoxin. One of the things I want to take up today is to settle in our minds what we expect to do with antitoxin. Schick has worked out a very excellent scheme for dosage. He states that in 90 per cent Of cases we should give 100 units for each kilogram Of weight.
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