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Certain preliminary difficulties had to be overcome. For instance,
no indication was given of the dosage of the serum necessary to produce
passive immunity. The Health Department stocks Anti-Diphtheritic
Serum in two strengths, 8,000 units for curative purposes and 500 units
for prophylactic purposes, i.e., the latter is 1/16th of the former. My
information was to the effect that for curative purposes 50 c.c's of the
Anti-Scarlatinal Serum ought to be injected, and I assumed that for
prophylactic purposes 3 c.c's or l/16th of thecurative dose might be taken
as, approximately, the proper quantity to administer. As a fact, in order
to be safe rather than sorry, I gave 2 c.c injections to 104 contacts. This
quantity was quite insufficient and I have since learned that the prophylactic
dose should be 10 c.c's, and increased the quantity to that amount.
73 of the cases had no re-action.
I believe, however, that the serum used is the anti-toxin of the
Scarlatinal poison, and that it is only a matter of a short time until
Scarlet Fever can be brought under effective control. The serum is prepared
according to Dochez's method, and is supplied to me in 10 c.c.
hermetically sealed ampoules. There are two reasons for my belief that
the anti-toxin is the appropriate antidote to the Scarlatinal toxin. First,
the cases that developed shortly after inoculation were exceedingly mild
and one or two appeared to abort.
The following is a short resume of these abnormal cases:—
Mild Cases:—
K.B., 8 years, inoculated 6-9-24.—
7-9-24.—Sore throat.
8-9-24.—Tongue furred, raised papillae, rash on chest and back,
morning temperature, 98.6 deg., evening, 101 deg.
Evening—tongue clearing; rash extended, child not ill.
9-9-24.—Morning—tongue and throat almost normal.
9-9-24.—Evening—symptoms almost subsided, rash very faint.
Child desquamated; temperature only once registered above
normal. No complications.
16-10-24.—Satisfactory.
J. D., 1 year, inoculated 20-10-24.—
18-10-24.—Very fretful and profuse nasal discharge.
20-10-24.—Rash, throat very red, tongue suspicious.
21-10-24.—Temp. 99 deg., and mother reported that child was
"fretful" during night.
22-10-24.—Rash disappeared, throat normal, tongue peeled.
23-10-24.—Satisfactory.
4-11-24.—Powdery desquamation.