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161
The returns of the products prepared and issued during the year together with those for
previous years are given in table X, page 172.
In the report for 1933 attention was drawn to the fact that the output of diphtheria antiI
oxin alone constituted a record annual output for these laboratories, the amount issued, namely,
103 million units, being 40 million units more than the issues made in the epidemic year, 1921.
Owing to the continued prevalence of diphtheria of a type necessitating in many cases larger
doses of antitoxin, the output of diphtheria anti-toxin during 1934 has exceeded that of 1933
by more than 40 per cent., 579 million units having been issued. The diphtheria antitoxin is
issued as a refined and concentrated globulin solution of antitoxin in sealed ampoules of 2,000,
8,000 and 20,000 units in 1, 4 and 10 c.c. ampoules, respectively. The numbers of the various
ampoules issued were as follows:—6,200 of 2,000 units, 61,400 of 8,000 and 3,700 of 20,000.
The demands for streptococcus antitoxin show a steady increase, being 14 per cent, greater
than for the previous year. This product is issued in sealed ampoules of 10 c.c. and 5 c.c.;
approximately 28,000 of the. former and 3,000 of the latter were issued in the course of the year.
The actual volumes of diphtheria and of streptococcus antitoxins issued were as follows:
diphtheria antitoxin, 289 litres; streptococcus antitoxin, 291 litres; a total of 580 litres of
refined and concentrated antitoxins. The corresponding figures for 1933 were: diphtheria
antitoxin. 201 litres ; streptococcus antitoxin, 254 litres ; a total of 455 litres.
In order to meet various requests and after consultation with the medical superintendents,
it was decided to make the following additions to the list of products prepared for issue: 20,000
unit ampoules of diphtheria antitoxin and 5 c.c. ampoules of streptococcus antitoxin.
Dr. E. W. Todd has continued his investigations of haemolytic streptococcal
infections. The problem of serum therapy against haemolytic streptococci is complicated
by the fact that antibacterial sera are strictly type specific in their action,
and are therefore of doubtful use in the treatment of disease due to a multiplicity
of types. The observation that the haemolysin of streptococci is antigenic, which
was published by Dr. Todd in 1932, is being put to practical use for the diagnosis of
infection by haemolytic streptococci particularly in rheumatic disease.
Potent antistreptolysin serum has been prepared in these laboratories which in
a dilution of 1 in 100,000 neutralises streptococcal haemolysin. The effect of this
serum on infection with haemolytic streptococci is now under investigation.
Dr. L. F. Hewitt has continued his work on serum proteins, paying special
attention to the problems encountered in the preparation of antitoxins.
All the copies of the first edition of Dr. Hewitt's monograph on " Oxidation
Reduction Potentials in Bacteriology and Biochemistry " having been sold, advantage
was taken of this opportunity to prepare a new edition brought up to date,
and this was published in the early part of the year.
The work in connection with active immunisation against diphtheria of children
in the Council's residential schools, children's homes and residential special schools,
referred to in previous reports, was continued during the year, and subjoined are
particulars of the work done up to 30th June, for which period alone completed
statistics are available. In the fifteen residential schools and homes and in the ten
residential special schools included under the scheme, 1,208 children were tested
for their susceptibility to diphtheria and 448 gave a positive reaction. Of these,
400 received the full course of inoculations and were afterwards found to give a
Schick-negative reaction. For various reasons the remaining 48 were not tested,
most of these children having left the schools before the inoculations were completed.
For the clinical comparative tests constantly required in connection with the
work, thanks must be accorded for the valuable services rendered by the medical
superintendents and medical officers of various hospitals and especially to Dr.
Rolleston, medical superintendent of the Western hospital, who granted the
necessary facilities, and to Dr. Laurent, senior medical officer of the hospital, who
carried out various standardisation tests. Dr. Greenfield, assistant medical officer,
formerly at Joyce Green hospital, and later at the Eastern hospital, also assisted in
this work.
This opportunity is again taken of expressing thanks to the Medical Research
Council for providing regular supplies of standard diphtheria antitoxin.