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42
diphtheria protein in the succeeding ten or fifteen years of life, many of
these previously susceptible children develop some degree of immunity,
although about one-third of the young adult population is still capable
of being infected with diphtheria. The ideal precaution, if parents only
knew of it and would use the safeguard, would be to immunise all children at
the age of six months. If this were done many lives would undoubtedly be
saved; in London during 1922, 1,137 nersons, mostly children, died from
diphtheria; another 1.1,135 persons suffered from an attack. Most, if not all, these
deaths and illnesses could have been prevented.
Three injections each of 1 c.c. of a suitable anti-toxin mixture will cause
about 85 per cent, of susceptible children or older persons to develop sufficient
anti-toxin to produce marked, if not absolute, protection against diphtheria. The
remaining 15 per cent, can be immunised by a further course of injection, repeated
if necessary yet once again. The development of immunity is a natural proccss and
is therefore not rapid; from one to six months must pass before the previously
susceptible persons becomes immune; although immunity can be produced
by the injection of anti-toxin such artificial immunity lasts only for n
short time, for a fortnight to a month, but the natural immunity caused by the
toxin-anti-toxin injection persists; in at least 90 per cent, it lasts for a certainty
for six years and in all probability for the remainder of life.
A very large number of parents of children residing in Holborn were informed
by the Health Visitors and Sanitary Inspectors of the possibility of preventing
their chi'dren from catching diphtheria. They were told verbally and given a
leaflet written in simple language.
As the result of the persuasions of the staff, chiefly of the Health Visitors,
a considerable number of persons (133) were tested; of these a very fair proportion
—98 out of 13.3 (G6 per cent.)—completed the course of immunisation.
This work has been carried out by Drs. O'Brien, Okell and Eagleton; we are
indebted to Mr. Henry Wellcome for providing the facilities.

*Did not continue inoculations.
Total attendances during the year 711