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realised if it is borne in mind that as many as six needlings mav be
necessary to each case, i.e., 2 for the Schick test, 1 for sensitising dose,
and then 3 immunising doses to those who gave a positive result to the
Schick test. To help in the work and to demonstrate the technique of
this treatment, practitioners were asked to be present upon the 4 or 5
occasions on which it was necessary to attend at the Home. The whole
procedure was carried out and supervised by Dr. Monckton Copeman
of the Ministry of Health, to whose indefatigability and courtesy,
everyone connected with the affair is exceedingly indebted. Briefly
the result was as follows:—
Number Schicked 142 (9 adults and 133 children). After 3
examinations it was decided that 86 were positive and 56 were negative.
Three examinations were thought necessary because of doubtful or
pseudo reactions in a number and combined reactions in 2. By
combined cases, is meant cases where reaction took place in both arms —
in the arm to which the Schick test was applied, and also in the
"positive" arm where saline solution was injected as a "control."
It was decided to give toxin anti-toxin to the whole of those
giving a positive result. A sensitising dose was first given, consisting
of 0.1 c.c. of the Burroughs, Wellcome & Co. prophylactic; this is for
the purpose of detecting any case peculiarly susceptible to this preparation. Subsequently 3 doses of 1 c.c. each was given at 7 days intervals.
No untoward results were detected during the whole procedure, though
in one or two cases there was a tendency to urticaria. Since that date
there has bean no case of diphtheria notified from this home. One of
the inmates which had been treated in this way was notified by the
Medical Officer in charge of the Home as being a case of diphtheria,
but this on subsequent examination proved not to be so.
It was subsequently resolved to subject all new entrants at this
Institution to immunisation by toxin anti-toxin; this, I understand,
has been done.
Diphtheria Anti-toxin.
Apart from Institutions, in general practice diphtheria anti-toxin
is extensively used. During 1925, 352,000 units were supplied from
the Public Health Department. Anti-toxin is also obtainable at any
hour of the day or night from the Town Hall, and also from the NorthWestern
Fever Hospital, Lawn Road. Both these Institutions are on
one side of the Borough; and the western portion, which is unusually
difficult of access, is not provided with equal facilities. I have several